The biggest mistake in human history!? What is he talking about? We will get to that and more in this very thoughtful show with Dr. Mark, pioneering physician and legendary endurance runner.

Dr. Mark has been quietly changing the world with his devoted efforts to get people healthy, both inside the medical system as a physician and also a fitness enthusiast who conducts running clinics and opened the first ever barefoot-focused running store in the USA. He is a highly accomplished runner, with an absolutely astonishing and perhaps unrivaled streak of running a sub-3-hour marathon 30 years in a row. Mark recently wrote a book to convey his unique and broad-based health and fitness message, titled Run For Your Life.  

As a cutting edge thought leader in ancestral health, you could say that Mark hails from an unlikely home state of West Virginia. This state just earned the dubious distinction of being the fattest state in America according to the CDC. Alas, they are also the most honest citizens, as they also admitted to their high obesity rates in the “self-reported obesity rates” graph that accompanies the official CDC graph.  

This show gets into all kinds of juicy topics, and Dr. Mark pulls no punches. He observes that the creation and promotion of the USDA Food Pyramid has been “the biggest mistake in human history,” one that has led to millions of deaths, not only in America, but in all the other western nations that we export our culture to. Dr. Mark believes that the hyperinsulinemia (chronically excessive insulin production) that results from eating by the food pyramid is now the “biggest crisis in humanity” and everyone should stay away from foods that he refers to as “white death.” Indeed, as Dr. Doug McGuff observed in his book, Primal Prescription, if type 2 diabetes continues at today’s accelerated rate, the ensuing expensive long-term care for this condition is on track to bankrupt the US Treasury by the year 2060.  

This is serious stuff that we seem to overlook, buried under the billions of dollars of marketing efforts by processed food manufacturers. American dietary guidelines are changing (at a snail’s pace it seems, but at least it’s still happening) but Dr. Mark rightfully believes that ridding the patient of the guilt they carry over their weight is key. They need to know it’s not their fault if they are obese or have a metabolic disorder, as the truth is, there are so many factors that contribute to this. Dr. Mark mentions a great Huffington Post article, “Everything You Know About Obesity Is Wrong” and uses the analogy of a classroom of kids to illustrate society’s view of obesity and fat shaming: “If one kid out of a class of 30 is failing, then it’s maybe about that kid, but when 2/3 are failing, it’s not about the kid – it’s about something else.” As he points out, “it’s inhumane” for people to pay for diet programs where they’re severely restricting calories to starvation level, because they spend all this money only to gain it all back, and find themselves again in the same place – shouldering the blame for something that they don’t even know isn’t their fault. Dr. Mark’s counter solution to this problem is empowering people by giving them the knowledge they need to truly understand that their health is in their hands. His patients have experienced enormous success because they have been given the tools they need to make lifestyle changes that have lasting, long-term effects. Enjoy this show as Dr. Mark fuses sharp intellect and curiosity with deep empathy for his patients, and illuminates many integral, underlying issues central to our food system that could be holding you back from thriving and functioning at peak performance. 

TIMESTAMPS: 

Brad introduces his guest who is actively changing the backwards medical community where he lives in West Virginia, the most obese state. [03:44] 

The idea that eating fat causes you to get fat and causes heart disease has been refuted. It is widely accepted that sugar is the problem.  [07:06] 

Medical schools are finally paying attention to diet. [09:40] 

Some believe that you should have a plant-based diet. [12:44] 

People don’t understand about fruits. If you want to build up body fat, eat fruit. [16:27] 

What used to be viewed as the good diet for triathletes has to be refuted. [21:47] 

Dr. Mark runs sub three-hour marathon. [31:18] 

The US Dept. of Agriculture’s food pyramid could be the biggest mistake in human history. [33:05] 

If your HDL is high it is a predictor of cardiovascular disease. [38:38] 

Fat in the midsection is a warning. [44:36] 

Fatty livers have now been seen in kids. [48:47] 

Anything that involves calorie restriction to starvation levels, is unhealthy. [55:41]  

US dietary guidelines are slowly changing. [59:50] 

If the healthcare provider can assure the patient it is not their fault, it is a big step forward. [01:01:24] 

“There is more money spent in the USA on medical care and consumer products relating to weight loss than on national defense.” [01:04:56] 

Why isn’t there more talk about the blood test for insulin? [01:05:58] 

Other societies do not have sugar sweetened drinks and garbage and junk food. [01:10:39] 

Whether the change is slow or cold turkey, it is up to the patient how they want to improve the health. [01:13:49] 

LINKS:  

Cucuzella Running Streak 

Run For Your Life by Dr. Mark Cucuzella  

Gary Taubes 

Dr. Timothy Noakes 

Dr. Robert Lustig 

Eliud Kipchoge
Hyperinsulinemia 

Lore of Running 

Everything You Know About Obesity is wrong 

Why We Get Fat 

Nutrition Coalition 

Diabetes and You 

Vinnie Tortorich 

Kraft Curves 

Two Rivers Treads 

Dr. Mark’s Desk 

Obesity map. WV is #1 for obesity but also honest! 

LISTEN:

Download Episode MP3

Get Over Yourself Podcast

Brad: 00:00:00 Welcome to the get over yourself podcast. This is author, an athlete, Brad Kearns, discovering ways to be healthy, fit and happy in hectic, high-stress, modern life. So let’s slow down and take a deep breath. Take a cold plunge and expertly balance that competitive intensity with an appreciation of the journey. That’s the theme of the show. Here we go.

Brad: 00:03:44 Hi Listeners, I’m pleased to introduce you to an amazing thought and action leader of the planet, Dr. Mark Cucuzzella. This guy is fighting a beautiful battle to make big changes in the backwards medical community, treating diseases that are so easily preventable by diet and lifestyle modification and also on the other side encouraging people to get outdoors and healthy and run and run barefoot. He opened up the first barefoot dedicated running store in the United States. He’s in a hospital environment where he convinced them to get sugar out of the hospital, cafeteria and patient’s plate. Yes, there’s a ton of sugar on any hospital plate. Take a look if you’re visiting someone or you’re happened to be there. What a joke. What an absolute disconnect from what your body needs after something traumatic like a surgery or an illness and there they are feeding you Sherbert and skim milk and all the other garbage on the hospital tray.

Brad: 00:04:49 Dr. Mark’s doing something about it. He’s making great strides in his home state of West Virginia and how unlikely as that, because West Virginia just earned the fabulous distinction of being the number one most obese state in the United States of America. There’s new maps that come out with color coding only Colorado and Hawaii has an under 20% obesity rate and then the worst of the states are trending up there up to 40% of the population obese. Dr.. Marks States that 67% two out of every three west Virginians are in that danger category of their BMI off the healthy charts and into the overweight obese zones. Interestingly though, West Virginians are the most honest people in America because there’s another graph called the self reported rates of obesity and West Virginia is the same color. It’s red on both maps where a lot of these other states are in the red zone, the danger zone in terms of their percentage of obese, but they think they’re green or a blue.

Brad: 00:05:58 Oh man, that’s pretty tough. So West Virginia acknowledging the problem and guys like Doctor Mark helping these patients. He has a low carb clinic. How about that? You would you like to see a physician who’s already embracing the primal Paleo ancestral health principles? As soon as you walk in the door, you don’t have to fight a battle with your own doctor, which is so common these days, and we hear about it so much with ancestral health enthusiast. So we go on a wide ranging hardcore discussion. I know it’s fast moving at times and some scientific insights come into play, uh, with a necessary prerequisite knowledge of things like hyperinsulinemia, the chronically excessive insulin production that happens when you eat a high carbohydrate grain-based diet, and all the havoc that wreaks inside your body with oxidation, inflammation, the precursors to heart disease, the true precursors rather than the long mistaken notion and finally being overturned by respected scientists in consensus that eating fat causes you to get fat and causes heart disease.

Brad: 00:07:06 It’s been strongly refuted now and widely accepted that sugar is the problem. Dr. Mark references the work of many of his great colleagues like the Science Journalists, Gary Taubes, who’s written some of these transformative books in the scene. Dr. Timothy Noakes in South Africa who’s also fighting a royal battle. And believe it or not, if you Google this, you’re going to be amazed, but he’s on trial in the courts of South Africa for recommending to patients that they cut out sugar and eat more fat. It’s absolute joke, but this guy is standing strong against a lot of pushback, especially in the academic world that he comes from. So man, you gotta respect guys like Dr. .Cucuzzella, Dr.. Noakes, Gary Taubes, trying to tell the straight story, Dr. Robert Lustig, other people that are quoted in this wide ranging discussion and of course with Dr. Mark being such an accomplished marathon runner, we had to get a little tidbit discussion in about the recent world record performance of Eliud Kipchoge running a 2:01:39 marathon and what Dr. Mark thinks about that cause get this, this guy has one of the most impressive streaks you’ve ever heard about.

Brad: 00:08:17 He has run 30 consecutive years, a sub three hour marathon. He has an all time, best of two 24 which is just about Olympic trials qualifying back in his early days. But he’s still going strong. He’s hit 50 plus and carrying on like a machine. He finished this podcast and went right back into his role on call for the emergency patients coming in. So this guy goes hard. He’s got a lot to say. I hope you can hang on for a ride and get incited and decided. I was going to say inspired somehow out of my mouth came and, and I’m going to leave it in there because I want you to get excited about some of the nonsense that’s going on in the medical and the healthcare scene and the battle that Mark’s fighting. And also inspired to eat healthy, get out there and exercise, maybe consider a barefoot experience. Cause Dr. Mark’s so big on that and he’s run many of these fast marathons in minimalist shoes. Fun Times with Dr. Mark Cucuzzella, Dr. Mark Cucuzzella. We are lighten it up. We were, we were already going off on our many favorite hot topics. So I said, hold on, I’m pushing record and we were talking about, uh, the militant Vegan influence and some strange stuff that’s going on. Light us up, man.

Mark: 00:09:40 Yeah, that’s a battle, Brad. So you know, medical education now is, you know, we’ve made some strides that we don’t allow pharmaceutical companies to just waltz in and you know, sell their wares and give their cherry picked articles to students who are highly influenced. But what we’re seeing now is unfortunately groups like physician committee for Responsible Medicine, American College of lifestyle medicine. So these groups are dominated by what is now kind of referred to as a whole foods plant based diet. If you hear that term, w f he be I think would be the right an acronym. It’s code from what I’m reading, you know, and what I see given out to students as, I mean I probably eat a WF he be, you know, so the volume of my plate, Brad, it’s probably plants the volume, the most volume. But certainly if I don’t have anything of nutritional substance on that, you know, some form of fat and protein to go with my veggies. You know, with a nice bottle of primal kitchen, you know, Greek goddess,

Brad: 00:10:49 no Duh, Duh, Duh. I got to put music in the background. If you’re going to do a commercial.

Mark: 00:10:52 I never found that my store shit. I got like, oh or variety five varieties in my fridge. But that’s so, I mean the, the Greens are great. You know, those are nutrients, but they’re called fat soluble vitamins. And you know, you do, I mean, you’re only to be doing endurance sport just to be doing normal human activities. You need essential fatty acids and essential Amenia amino acids. So if all I ate all day was plants, I think I would be eating all day as a human probably isn’t a good thing. You know, somehow we made it further up the food chain to not have to be, you know, eating plants, eight straight hours, 20 straight hours a day. But this movement is not really based on science, you know, so I can see patients and I don’t have any political agenda. I don’t have any products to sell, you know, I just want them off of the carbage, you know, which is the junk, which could be called like the white death, you know, and not be another way to phrase it.

Mark: 00:11:44 You know? So we all agree that we need to get off of sugar sweetened beverages and processed junk. But when we go out there and push to the population, they should be eating 95% plants, you know, no animal products at all and somehow that’s the way it is. I mean, that doesn’t, that’s not sounded in any medical evidence. Certainly not in human biology and certainly not in human evolution. So when that’s pushed out to medical students as the way to health, you know, just, and they get a free pass. So these groups are held up as authoritative. You know, they have doctors’ names behind them, you know, they have board certification. You know, you can take online courses, you know, spend your money to get a certification. You can go to Colin Campbell’s website, you know, on the Cornell. And you know, you could be like anyone who has no medical background and take an online course teaching you how to teach the world that they should eat plants only, and put a shingle up and then teach this.

Mark: 00:12:44 But they, they, they make their way into medical schools. Because, I mean, just for example, last year there was a book without by Physician’s Committee for Responsible Medicine called nutrition’s guide too. [inaudible] nutrition clinician’s guide to nutrition. It’s a free resource either PCRN and uh, my administrator hands me this box of books is and says, Hey, this here’s a free gift from the PCRN, you know, to give to the students. Do you mind, uh, given this book to the students during your lecture? And I kinda grabbed the book and Oh, and I paged through it and I like just open cardiovascular disease, you know, like diagnose or the the, the therapy is all plant based nutrition. Find nutritionist who teaches plant based nutrition. That’s it. That’s the remedy. So I agree. I mean I think we probably agree on 80 to 90% of things, you don’t get rid of junk food, but the, the world right now is suffering from a condition called hyperinsulinemia, you know, so unless what that person, if so here’s how it is.

Mark: 00:13:47 Maybe you want to throw another questions or just let kind of, let me go on a little bit on this Brad. I will clarify. So this was a, a podcast from the British Journal of Sports Medicine, from one of the leading pediatric obesity specialists. And this one made sense to me and how we need to look at this as a society. You know, so if we have 30 kids in our grade school class and one kid is failing, maybe it’s about the kid, but when two thirds of the kids are failing, it’s not about the kid, right? Like you can’t blame the kid. Maybe there’s a system thing, you know, multiple inputs going on that is contributing to two thirds of the class failing. So you’ve looked at the CDC maps, you know, 35 to 40% of my state is obese and 67 ish percent are overweight. So the majority are failing the class. So we have to look deeper. But it is hyperinsulinemia is the root. So and let, so if two thirds of the folks who are obese, overweight, that’s primarily a condition, high insulin load hyperinsulinemia. If you can address that with a plant-based low carbohydrate ish nutrition, you know, with tons of oils, maybe pretty good volume of nuts, you know. But keeping that insulin load down. Maybe you can make it, I’m going to turn this, this beeper off here, dude. Hip Policy, sir.

Mark: 00:15:17 Okay. Sorry about that. I had a timer going there. Sure, yeah, yeah. That’s my good time. Someone that their UPS guys at your door that’s [inaudible] retake there on like the that hyperinsulinemia so do you want to read Kind of just read, pick up. Yeah. So Brad, I think what the population of medical providers really need to understand that if two thirds of the population are overweight or obese, an over 50% has prediabetes. You know, there’s such a, a loop in that venn diagram. You know, there’s pretty much one in the same then unless our guidelines and what we teach students in the general population is we need to identify hyperinsulinemia and if they have it then whatever they do in life, not just food. You know, if you’re on night shift and there’s stress and cortisol and those are hot. So we got to get at that as the root cause.

Mark: 00:16:27 And, but most of these, a whole food plant based nutrition guidelines, I don’t even address hyperinsulinemia if I look at that list of things that they want you to eat. If I’m a diabetic, you know there’s tons of grains in there, a lot of fruit. People do not understand Brad, that fruits, you know, this is a, I’m not making this up and you can Google it. So if a hibernating animal wants to fatten up before hibernation, what foods do they seek out? Fruit. Right? Cause they, you know, the, the bear cannot go to McDonald’s. So that’s fine. What is available in their environment. And so the most and insulin resistance leads you to hibernation. You know, you want to build body fat. So all of these animals in nature that want to you know, hibernate and put on body fat, they seek out the sweetest things they can find.

Mark: 00:17:16 So when we kind of loop them together and we tell [inaudible], well you can have five servings of fruits and vegetables and that’s all good and it all work out well. But that could be like five servings of kale, which in my state, they live in they don’t even know kale from a cow. Hey, they don’t, or five bananas or five cups of, of uh, you know, have you seen like you’ll get them at the dollar general, you know. So to most people in my state, a fruit would be a can of sweetened canned fruit. You know, like pineapple, fruit cocktail. Nope. Fructose is the elephant in the room. It goes right to the liver, you know, so anything that’s high fructose load, all right, we eat and drink a canned fruit or six bananas at a time because you’re [inaudible] Oh, you’re supposed to have your five fruits and badge if it’s working for you, great. But I haven’t seen that work. Yeah. So I’m waiting for the dayThey do that this works. So, so if anyone has data that that works enlightened.

Mark: 00:18:16 Yeah. I think the, the, the argument and the strong voices in favor of this, uh, plant dominant, uh, animal absent diet, uh, usually is a vibrant fit looking a promoter. And I think the, the following are a lot of people that, uh, it makes sense intellectually to think that, uh, fruits are so nutritious and they have a nutritional value in Jamba Juice will tell you about all their antioxidants. Uh, but it seems like you’re onto something when we’re overlooking the issue of hyperinsulinemia when we’re talking about, uh, the recommendations to avoid fat in the diet. And by default you’re going to be going over to high carbohydrate intake or eating all day like the gorilla.

Mark: 00:19:12 Yeah. And they call it like in the literature brand, they call it the Healthy Person Diet. So if you go into Boulder, Colorado,

Mark: 00:19:19 Brad’s making Brad’s making scientific sense. He, he’s, he’s tapping into an actual validated concept. I love that.

Mark: 00:19:28 Yeah. It’s called the Healthy Person Diet. I mean [inaudible] Problem with video……..;.

Mark: 00:20:10 Brad, there’s a phenomena in the literature called a Healthy Person Diet and I think it’s pretty easy to define. So if you go to boulder, Colorado, maybe San Diego, California, and you have a fitness instructor, maybe someone teaching spinning class or crossfit instructor, but they tend to be more Paleo a yoga teacher, you know, who does everything right in life, right? They eat, Dr.ink, no sugar Dr.inks, you know, they don’t even drink beer, no alcohol. You know, they exercise eight hours a day, they get sleep, they get sunlight, they do all these good things and they eat a vegetarian diet. And they look pretty healthy. That doesn’t mean that if you eat the vegetarian diet, if you are not that healthy person, you will get healthy. But we tend to association isn’t causation. So you know, you go over to these small islands in the Mediterranean, you know, and they might call them things like the blue zones, you know, and they have community, they eat dinner together, they eat for two hours. You know, they don’t put grandma in a nursing home, they walk from place to place. And you know, they eat a lot of, you know, olive oil and fruits and vegetables and all that stuff. But they don’t have insulin resistance. They don’t have high insulin levels, you know, and they, and they eat this wonderful kind of almost romantic diet, you know. But can you apply that to the general population if that diet contains a significant amount of carbohydrates? We just don’t know. You know, all we do know is can we measure someone’s insulin level? And if it’s high, then we need to reduce that in that individual’s diet.

Mark: 00:21:47 But because you are healthy, you know, triathlon friend eats, you know, probably you back in the day Brad and you look at Dave Scott, he’s do a link to his site. You know, he was the carb guy, you know, and back in the day when he was racing Mark Allen, you know, he would skim the, uh, cottage cheese as Mark Allen says. He’d like do all kinds of stuff. Like he would not look up happenings, diet any, I don’t know what led him. I think he had, well, he had arhythmia. He went into Afib and had cardiac issues and now he’s like turned it on its head. You know, he’s now let’s eat the healthy fat. And I think what he’s advised saying, correct me if I’m wrong, I’ve listened to him on podcasts, but you know, for the triathletes, he’s advising his, okay, I, you know, don’t do what I did then, you know, you know, for as much as he knew about training, he did not understand the diet because none of us did that. And we just, if the fire was hot enough, we just lit it up and we burned it.

Brad: 00:22:41 Well, I mean, Dr. Timothy Noakes was the world’s leading exercise physiologists in endurance scene and of course everything was happening inside the carbohydrate paradigm. So we didn’t know any better and not knowing any better. All this stuff is indeed scientifically validated, such as you need to keep slamming sugar down your throat if you want to perform, uh, for a long duration workout if you are eating in a carbohydrate dependency pattern. But no one knew that there was an escape hatch, uh, to, to get out of that trap of, you know, burning calories like crazy to make up for all the, uh, all the insulin you’re producing in your diet and the increased appetite and the inhibited fat burning.

Mark: 00:23:25 Yeah, a great read. I got to to see Timothy or prophecies or spectrally known affection on in South Africa. So three weeks ago I went out to the metabolic conference out in Columbus, Ohio, uh, hosted by Jeff Volek, who’s professor there at, at Ohio, at the Ohio State University. So Tim made his trip over and he gave a, an uh, a wonderful talk kind of through the whole history of this and he actually pulled up some of his old studies from like the 1980s where he was studying sports nutrition and because he was convinced that the carbohyDr.ates were the key, he actually ignored some of his own data. So it’s so nice when people kind of mea culpa because we’re learning every day. He went back to him and he’s like, I completely missed this phenomena that was happening right before my eyes because I was just looking at the carbohydrates.

Mark: 00:24:13 But you had to see the talk. It was just mind blowing. But he’s working on now, he’s working on [inaudible], which will be, I don’t know how many years it’ll take him to pull it off. He’s amazing writer, but he’s working on the sixth edition of the Lore of Running and he’s revising the whole nutrition section and he’s digging deep into the way a lot of these, um, for many of the, the audience out there, the Lure of Running is the Bible. It’s the fifth edition is, I think it was the late 1990s it came out, it’s like 1,015 hundred pages crazy. But he has like chapters on what all of these runners from legendary times did. And it was mostly, the fifth edition was mostly about their training methods. He didn’t mention much about how they ate. So he’s going to go put back in the, in the day he was, he was talking about this in Columbus, you know, they didn’t have Powerbars and power gels like these people running these crazy ultra marathons, you know, and slippers in the 1930s.

Mark: 00:25:08 I mean, they would do, I just got back from the Comrades Carathon in South Africa, which is the 90 k route. And I think this was the 95th year, you know, it’s, that’s, that’s Tim Noakes is, that’s where he learned a lot of his science was at the Comrades Marathon and a, these old school comrades runners, they didn’t have aid stations. They had maybe a few spots where they’d have these salty potatoes that was about it. And, um, but yeah, so he’s looking at what these folks that did extraordinary human feats did back in the day. And when he was sharing some of these stories that in Columbus, it’s like, wow, you know, it, it just comes around, you know, nothing new under the sun. It just all gets recycled. But we have to go back and look at the science. And I think we just had a blind spot there for probably about 40 years. And now it’s thanks to the work of Jeff Volek, Timothy Noakes, Stephen Phinney as being unremoved. You know, I’m just a an n of one who seven years ago got prediabetes. So I just flipped my food pyramid upside down and I feel good now. And that’s the main goal in life is feeling good and having energy every day.

Brad: 00:26:12 Oh my goodness. Dr. Mark, I didn’t know that. So you got a pre-diabetic, uh, warning red flag come up seven years ago. That was maybe around the time of Noakes as well. Or, uh, tell me about your thing.

Mark: 00:26:27 So an actually notes validated that I wasn’t looking crazy. So probably about seven years ago I was working on a project, which is the foundation of the book I just wrote, Brad, its called Run for Your Life. And it’s based on a project I did for the air force called the efficient running project, which was designed to try help people pass their fitness tests because the failure rates in India, very rates were going off the rails. And, um, I didn’t know anything about nutrition and I just did kind of a data crunch about why people were failing. And I noticed that, you know, it shouldn’t be surprising now, you know, but back then I was like, are they not trading enough? You know, maybe they need to just suck it up more and we all have our biases, but I wanted to throw out all my biases at that point. I was, you know, I’ve kind of prided myself on that. Like I didn’t believe anything because most of what we had learned was wrong. You know, gone through this whole journey of, of my foot, you know, start running barefoot. When they told me not to run after foot surgeries, I realized that most everything that was on a treatment model was backwards.

Mark: 00:27:24 So I looked at all the data on the fitness test and that the BMI chart and the failure rates were like parallels. I mean, if your BMI, was high, you failed the test no matter how much tt and I, I, it was by chance I came across an article by Gary Taubes and you’re familiar with him. He was one of the first investigative journalists engine nutrition. There was a New York Times article called “Maybe it’s all been a big fat lie”. And I read that and I was like, wow, that makes sense. And I looked at my own labs at the time and my fasting glucose was like 130 somewhere around there. And My HDL was low, Triggs were high and I was waking up every morning at two in the morning to need more cereal. I was by eating 900 grams of carbs a day, but couldn’t make it more than three hours without carbs.

Mark: 00:28:10 And you know, so essentially I was developing what’s called the metabolic syndrome, you know, I had multiple components of that. My whole family’s diabetic heart disease, so it’s genetic. And another one got Gary’s book and I, I spent like a week reading it twice. So good calories, bad calories. It’s like a 450 page tome with 1100 references, you know, it’s like, wow, this is, it is what it is. It’s like a Bible of the history of nutrition. And that convinced me to flip everything upside down. So that was my last grain, my last bowl of cereal. I just started eating eggs again and you know, just every fatty thing I could, you know, not to excess just, I just shifted my fueling source. I just felt good. All of a sudden I just took about two weeks. I felt good. And then I went down to South Africa.

Mark: 00:28:54 So I teach running courses and I met up with your buddy Dr. Maffetone we partnered up and taught a course called Health Fit You So you know, but I’ve been traveling around teaching these running courses. So I partnered with Tim Noakes to teach one down in Cape Town was full of bud, you know, the famous barefoot runner from South Africa. And Tim’s like, I’m going to give a talk on nutrition. I’m like, call out the topic. Cause I’d been reading about it and I’m sitting in the auditorium listening to Tim’s talk and he’s like dissecting the history of the food pyramid. And I’m like, oh my God, if Tim says, I think I’m right. You know, you never, none of us say we’re right or wrong. You know, it’s like, well, maybe if I’m right, I think this could be the right way. You know, you just have to be critically thinking about this.

Mark: 00:29:39 And you know, in an hour and a half he pretty much laid it out. But he predicated his talk to say, okay, before I am giving this talk, this has been five years of personal experimentation and reading everything I can and no one, and I know this is true, no one will out read Tim Noakes. So he does not just read the latest, uh, you know, Huffington post article and say, well, I guess that’s what I want to do. You know, before he’ll, cause you know, he’s vulnerable and it’s not up to trial because, you know, he suggested to a young mother that maybe he should, she should wean her child to eggs, meat, cheese. And that’s the stuff that is on the American Academy of Pediatric Healthy Food List, you know, which could be called low carb foods, but these are just normal foods. But he’s been under attack. But that validated that I wasn’t crazy. So it’s been, I think he and I in different parts of the world have been on a parallel path. Just trying to educate and let people try things that we don’t, we’re not dogmatic. It’s like if what you’re doing now is not working for you and you’re becoming more obese in the middle while training four hours a day for your triathlon, maybe try something different and see how it goes. But that’s, yeah, Tim looks like 1 million bucks now. So to have the energy, to rewrite the Lure of Running, he must be doing pretty well.

Brad: 00:30:59 And to give some context to the listener, uh, you’re an extremely accomplished marathon runner. Uh, you know, top physical form here. Uh, lean mean running machine. That’s gone what, 30 times 30 years in a row. Under three hours in the marathon or something.

Mark: 00:31:18 Yeah, 30 years in a row. Give them the lineup at Marine Corps. So Boston marathon this year, I was hoping to kick off 2019 but anyone’s a runner maybe watch that race on television in the comfort of your home. It was like, no kidding. It was like 40 mile an hour headwinds driving rain. It just horrible. I mean, I love being out there. So I had a jacket, you know, I was like full on gear, like expedition, but I ran a 304 2there and it was not a day to run fast. I think that winning ladies time was 239 and in second place, 244 I mean that’s pedestrian. The two men went under two 20. So I kind of wasted that day for a time. But I don’t run for time now, ran three or four there, but I’ll come back at Marine Corps marathon in about five weeks, maybe Brad to somewhere in the end of October. But I feel good. I feel fresh if there’s not, you know, horrendous weather conditions, I should be able to go under three this year. If it doesn’t, some happens, it’s no big deal. But you know, I feel fit enough to do it again.

Brad: 00:32:24 Oh, I’m sure if you, uh, if you bust a three Oh one there, you’re going to find a late December marathon and, and throw down under good conditions. So I have faith in you, man,

Mark: 00:32:38 Cal International Marine Corp. I’m committed.

Brad: 00:32:40 Okay. So this metabolic problem came up in the midst of this tremendous devotion, devotion to running and uh, you know, low body fat levels and on the outside, uh, looking like the physical specimen to uh, parade around for the state of West Virginia where you’re living and you referenced earlier that um, they, they’re ranked number one as the fattest state in the union.

Mark: 00:33:05 Yeah. So I’m just trying to help my state and my main message to the people. So obesity is not some individual flaw. You know, as we’ve mentioned the beginning of this podcast, three quarters, two thirds of the class are failing. There’s environmental issues. And your, you had pulled up, something interesting that I hadn’t pulled up is that they’re the most, we’re the most honest state, so self-reported obesity rates. We are the highest. So many. We kind of know what it is and it is what it is. But that still doesn’t get us away out. So, you know, I’m, I’m like fighting wars on three fronts to try to say, if we put out public health campaigns, Brad, that don’t address hyperinsulinemia that kind of go halfway. This is no kidding. This is the biggest crisis to face humanity. And I’m not making that up. You know, I mean I would, I would say just, you know, cart blanche the Food Pyramid was probably the biggest mistake in human history.

Mark: 00:33:59 If you look at lives lost, costs, and suffering, think of diabetes, cardiovascular disease, obesity, you know, that has ticked up since 1980 you know, so to reverse that is not going to take small incremental measures. I mean, this is for full frontal assault, so we can’t work around the edges. And you know, I’m pretty outspoken that if something does not address hyperinsulinemia, if we just tell kids to eat more fruit everyday and obesity’s magically going to go away, you know, I think that’s all good. Or maybe get out and exercise a little more, you know, less screen time. I mean, I wouldn’t disagree with that. But if we’re looking at reversing obesity, it’s not, that’s not going to reverse obesity. And that’s where I think there’s a lot of confusion in public health. You know, there’s all these public programs and you know, incentivizing people to do these things, which are all good.

Mark: 00:34:48 I mean, I totally, I mean that’s my life. I don’t spend six hours in front of a screen, but to reverse obesity, it’s going to take policy, you know, at the state and national level to, you know, to decrease access to the toxins, which is fructose mainly, you know, so the dose makes the toxin, you know, so you and I, when we were kids, maybe if we want our little league baseball game, we went out and we got an eight ounce Coca Cola and one of those little cans and that was like a big ass treat. Right? You know, birthday party, you’d have a coke, but we could deal with that. But if that’s every day and it’s in 26 ounces, then it’s not going to work out in your Capri Sun. [inaudible]

Brad: 00:35:26 Back in my childhood, I, I remember, uh, consuming a lot of candy and I would love to go with my buddies to the candy store and grab a bunch of candy bars on a, on a summer day or go and get a slurpee. But guess what? We arrived there on our bicycles. And so we were riding in the hot summer sun in Los Angeles and climbing up very steep hills at the end to get back home. And so that element, you know, mitigated some of the damage. But today it seems like we have so many disastrous modern consequences from lack of sleep, too much artificial light, uh, messing up the appetite hormones kicking us back toward sugar dependency than the readily accessible sugar. Um, it’s sorta like we’re clumping them all together and then someone says, hey, why don’t you try this Vegan cleanse? And I feel fantastic and most likely the average person going through daily life and eating a standard junk food diet, if they clean things up, they’re going to feel great and they’re going to have a thumbs up in favor of uh, this, this common, uh, strategy to just go super clean and not to not harm the animals either. And then I guess that gets lumped into a solution whereby maybe longterm, uh, eliminating that fat from the Diet, it’s going to have some consequences relating to satiety and compliance.

Mark: 00:36:47 You bring up a great point there, Brad. So then you know, so I would completely agree. Like if you want complete Vegan, it’s similar to me as like a fast, so if you took someone who is full catastrophe, you know, which is like my state right there eating McDonald’s, Dr.inking sweet tea and for 30 days you went pure Vegan, right? She just got rid of all this shit and you’re just a kale for 30 days. You are going to get better. You’re going to feel better. You know, your insulin levels are going to go. But that’s for, that’s like a fast or you is basically you just stop eating. You know it’s, but you need something in your stomach. But that does not mean that for the rest of your life you should just eat kale. So that there’s so much confusion. But I felt, you know, I did this for 30 days. I felt great. It was like a 30 day cleanse and maybe that for some people they do need that. They’d like totally get off the sugar addiction, you know. So at that 30 day, you know, Vegan or smoothie cleanse, you know, which limits calories and limits fructose. If it’s a Veggie smoothie, not a mango smoothie, you know, they are going to feel better and that’s good. So I like if people want to do something like that, I’m all for it. Like if I do it for 30 days, anything to get you off of the garbage and the white death, you’re good. But then you have to reset into something that’s going to maintain your health. You know, to the day you have to jog into the nursing home, you know, not be wheeled in there with a chronic diseases.

Brad: 00:38:16 Right. And in a guy like you lean and mean and dropping three hour marathons, but having these adverse blood values, something, something, sinister is going on inside without you even knowing it. I imagine it was a perhaps a surprise to see, uh, see you come into the same category as the average obese person.

Mark: 00:38:38 Yeah. If you didn’t know I ran, you know I was one of the guys who did run it off cause I liked to run but if you looked at my labs, you know, you wouldn’t have guessed I was like, you know, winning marathon races, which I was winning some races at the time but now my labs have come, you know, my HDL is like 106 you know, for those of you that don’t know what that is, that’s like super high in the best predictor of cardiovascular disease. If you just look at the cholesterol, you know, it would be your total over HDL or your or HDL over triglycerides. So when your HDL is high, it’s an indicator that your metabolic processes are well, but the, the true test is called a coronary artery calcium score. You know, that’s the, the test that looks under the hood.

Mark: 00:39:19 You have any plaque, you know, are you good? And knock on wood, mine was zero a couple years ago, which is like the 15 year warranty. So whatever I’m doing have done, you know, luckily, um, I don’t have any plaque on my artery so I’m going to keep doing the same thing because I’ll take a score of zero because it’s almost impossible to have a plaque rupture if you have no plaque. And plaque ruptures are the main cause of cardiac events. And for those of you out there, that’s a a great test. It’s the only test we’ll use for performance military pilots to allow them to fly performance planes. I can F16 or any fighter where they’re going to be pulling gs or any astronaut now who goes to space needs to have a score of zero meaning absolute zero because anything above that they do have some risk and you wouldn’t put them in a situation, you know, certainly pulling [inaudible] on a turn or up at the international space station and you know, they have a cardiac event, you know, you can’t call 911from up there, you know, they can international team and millions of dollars in a lot of human risks just to bring you home.

Mark: 00:40:21 So, so that’s an important test for people just on their own to read up on, you know, if you feel like you’re at some risk, your family say or a 50 year old guy like you and I and you just want to know like, okay, I know what my cholesterol, my blood pressure, I just want to know do I have any plaque in my arteries? Yes or no. It’s a $99 test. I don’t have any conflict of interest with that test. They’re available at most good quality radiology imaging centers. So consider that, look it up. People right now can look, you know, it’s an open access world,

Brad: 00:40:51 right? You can just go, go pop for tests.

Mark: 00:40:54 I’ll see him score, you know, compared to Framingham risk score, you know, you’re going to your doctors and your LDL is this and they’ll say, well your 10 year risk of cardiac diseases, this, you know, blows it out of the water as a predictor. You know, do you have zero CAC, meaning no plaque or you have, you know, you’re in the, Oh my God range. You know, you have score of a thousand units, you know, so that means you better figure it out, right? You better what is driving your plat. Each of us have multiple inputs to that.

Brad: 00:41:24 Did you improve that score from that day? Uh, six, seven years ago when you had your adverse blood tests with the high triglycerides, low HDL

Mark: 00:41:32 zero. So probably for some reason I had not accumulated plaque yet. If I caught it early enough. So some people can regress plaque. But what you want is, so say you’re our age Brad, your 50 ish year old dudes or lady and you do have some plaque. So you have to be informed about the test. I don’t want to scare people that they have plaque cause what you would do to prevent and stabilize it. So stable plaque is okay, it’s unstable plaque. That’s inflammation. So super high insulin loads, stress, you know tobacco use these things cause inflammation and certainly you know the the sugar metabolism and you describe it well in primal endurance, you know, the Tesla versus the car that puts out a lot of smoke. You know, so if you’re burning sugar all the time, you’re putting out a lot of exhaust and you know, for a simple way to explain it, that’s, that’s different than like a Tesla which puts out no exhaust.

Mark: 00:42:25 So you could run your marathon if you’re burning fat, you know, there’s no toxic byproducts. But if you’re just slamming workouts everyday, burning sugar, depending on your genetic adaptation to that, you know, we’re all different animals. But just buyer beware. If you’re burning sugar and working out hard every day, that it might not be cardioprotective. Find someone in your local area that can give you sound advice and give you these basic tests to, you know, as all good or maybe warning, warning sign. If you live near West Virginia, you know, come see me. I can at least have an honest conversation with you as an individual versus looking at population data.

Brad: 00:43:04 So Mark, you mentioned your family genetics and obviously you’re running, gave you some level of protection but not all the way there because of your diet. So I’m wondering, uh, when we walk around through the, uh, the cities of America and the, the buffet lines in Las Vegas and the, the, the cotton candy lines at the amusement park, are we basically seeing a, uh, lottery result based on, uh, the, the standard American diet, knowing to be, uh, excess in those white death foods of refined grains and sugars and also the vegetable oils. And then the level of damage, uh, that used sustain is relative to your familial genetic predisposition to accumulate plaque or to cumulate excess body fat?

Mark: 00:43:53 Yeah. And I’ve heard it explained like this, Brad, and I think this kind of spells it out. So it’s called a phenotype. You know, so phenotype is how your genes are expressed. You know, how, how does the flower bloom in the environment that it is? So we all have genes and that is what it is. You know, you can’t control that. You picked parents and that’s how it goes. But then the epigene gene is the genes that get turned on or off. So signals can turn those genes on or off. And then you have the environment anywhere. It’s not just about sugar. I mean, there’s probably things that we don’t even know. There’s a microbiome, you know, all these bacteria in our gut, you know, where we born from Caesarian section or vaginal I, was your mother Insulin resistant?. So there’s all kinds of things that turn genes on and off.

Mark: 00:44:36 So the things you can control is the environmental inputs because some people can do the same environmental inputs and their genes, they won’t have this expression of this insulin resistant phenotype, which is the expression of insulin resistance where if you went to a Walmart in my state, it doesn’t take very long to see it. It’s people with big waists. That’s going to be the marker. And in Asian countries, because they get the diabetes before the obesity, so you’re going to have just this little teeny valley, right? Like there’s little teeny potbelly, you know, this little teeny beer belly. But that could be completely nefarious to your health because that could be turning on all those inflammatory markers. So not everyone needs to be obese to have this, but if you’ve got some of that fat in the middle and you know it when you see it, you know, in the shower, like for a guy, I mean, no kidding.

Mark: 00:45:25 Here’s the test. If you can’t see or your friend in the shower, you probably should check your insulin level. You know, you’re in trouble. You know, you look down on and you can’t see your buddy there. So that’s, that’s a bad sign. If for the males, a lady who was a patient shared this one with me and we’re on a podcast, I’m in West Virginia, so if they don’t understand your language, you’re wasting your time. So she said this, uh, after she had lost like 40 pounds around the middle, she said, doc, for the first time in my life, my waist or conference is less than my chest circumference. And I was like, yeah, that’s a, that should be in the textbook, right? That’s exactly right. You look at the ladies and they got the big bellies and that’s, that’s, that’s the dangerous fat. You know, ladies will accumulate fat evolutionarily in the buttocks and the hips and they hate it because it doesn’t look good, but that’s not the unhealthy fat.

Mark: 00:46:15 That’s actually probably based on your genetic type. A means of, of survival, of, of being able to reproduce and feed children. You know, I know it’s not fair to be a lady to listen to this because you’re designed different, you know, you and I are designed to provide and protect. Evolutionarily it is what it is. And the ladies are designed to reproduce. If that doesn’t happen, the species is done. You know, that’s not being sexist or biased. That’s just, you know, you see that that’s endocrinology. You know, there’s different hormones influence fat accumulation in different places. But those kind of two simple things. If you’re a guy, if he can’t see your friend in the shower lady, if your belly is, is wider than your chest circumference, you better cut back on the carbs and deal with other things. Stress, physical activity. If you have sleep apnea, you know that another problem that drives this.

Brad: 00:47:09 When you say that the fat in the mid section for both males and females turns on inflammatory markers, what do you mean by that?

Mark: 00:47:19 Yeah, so there’s a whole pathway of inflammation that is dri00ven by what’s called visceral fat. So visceral fat, like when you go like say a, you know, I’ve scrubbed into all these operations, you know, and even c-sections now, you know, you’ll see a mom and there’s all this fat around the intestines around the liver and that, that, that fat produces and you know, IGF insulin derived growth factor. There’s all these interleukins and I’m not, uh, a physiologist or biochemist. But there’s all of these pathways that lead to arterial injury. You know, this micro injury, which will, which will be kind of the, the fertile field for plaques to accumulate. So cholesterol doesn’t cause heart disease. It’s at the scene of the crime. So all of these small dense LDL particles in the presence of inflammation will start to accumulate plaques on your arteries. It’s a long process, you know, and unfortunately now this process is starting in, in youth. I mean, even in the Korean War, when they did studies on autopsy studies on these 18 year old kids, they were surprised to see all of these plaques already on the arteries of 18 year olds. So, even in the 1900s this was starting to happen, you know, probably not to the degree as it is today. We see fatty liver now about a third of kids in my state. If you tested them for it, they would have fatty liver, which is, you know, a pathway to needing a liver transplant. You know, by their 30th birthday,

Brad: 00:48:45 a kid has fatty liver.

Mark: 00:48:47 Yeah, yeah. Look it up. Incidents of fatty liver and obese adolescents and it’s like, it’s the same thing, right? So if a child has visceral fat, if a, if a little kid in your neighborhood has a belly, the liver’s involved, it doesn’t spare the liver. So they do. If you actually did the test, I actually did an ultrasound or drew a blood test called a GGT. They have fatty liver. But the good news is if you catch it, it’s reversible. Robert Lustig did this study substituting Soda for Pizza, right? I mean like pizza you wouldn’t think is a good food. But I mean, not even going paleo or low car, just substituting Soda for FISA and 10 days fatty liver accumulates in 10 days. It reverses. So 10 days you can make change. It’s the fructose. It’s this, uh, that fructose is in all of the processed foods and the drinks were like a pizza crust is mostly glucose. Starch is more glucose, it’s a different type of sugar, but it doesn’t go right to the liver.

Brad: 00:49:45 Yes.

Mark: 00:49:46 Simply reversible if you catch it early enough. But once the liver starts scarring, you know, when you look at and stage fatty liver, which can now happen in 20 somethings at that point, too much damage just done unfortunately. And they can’t, they’re on the transplant list, which is really sad if they only knew, you know, when they were 10 that they could have dealt with it as it is sad, you know, seeing these transplant patients and they really had no idea what, why they are there and it’s just sad.

Brad: 00:50:16 Are we talking about escalating numbers here? I mean,

Mark: 00:50:20 yeah.

Brad: 00:50:23 Uh, the, the alcoholics destroy their liver and get on the transplant list. Like Mickey Mantle. He waited forever. But this is a diet related excess fructose consumption. Visceral fat, fatty liver transplant list. That’s not a good story.

Mark: 00:50:38 Are liver transplant now is fatty liver and it’s only going on up. So we can’t, I mean it’s a the iceberg, right? So we cannot afford, so I think in 20 years if all these people with fatty liver don’t reverse course and they all need a liver transplant, you better have a lot of motorcycle riders out there without helmets. And you know, I’m not saying that to be

Brad: 00:50:58 okay. No, that’s, that’s just, that’s a doctor sense of humor, man.

Mark: 00:51:05 They call it, alcoholic fatty. They call it alcoholic liver disease. And then they started seeing kids with it. So they had to change the name. It was the same exact process. Ethanol and fructose are five carbon sugars. They have to be dealt with by the liver. So they both go right to the liver. So the kid drinking juice might as well be, you know, having a know pint of Jack Daniels. But wait, six year old has the same problem it, but he’s not an alcoholic. So we have to make up a name. And it was, it’s called an NAFLD, we call it, you know, in short term, nonalcoholic fatty liver disease, which is basically fructose intolerance at the liver level. And it can be quickly reversed. And it has to be, because that’s cost of liver transplant. It’s like building more iron lungs Brad.

Mark: 00:51:51 So back in the day, you know, so this is kind of my, my call to your audience there. So this is a national crisis right? This is my, you know, my parents were alive in the early fifties I wasn’t, but polio, everyone was terrified, right? That maybe your parents could tell you stories if they’re still alive about, everyone was terrified of polio. They would line their kids up to get experimental vaccines. The March ofimes was crazy and it was a national crisis defined [inaudible] the cure. Jonas sock made the cure, sacrificed everything. But this was a national crisis. The option was build more iron lungs. Today we’re just building more dialysis units, hospitals, medical treatment centers, but it can’t sustain, we have to take this as serious as polio, but we’re not because there’s industry, you know, all big food. Big Pharma, I don’t get it, but I don’t see the urgency. It’s like, well, let’s just do a little bit. It’s better than doing thing. It’s like, no, doing a little bit is not either go all in to solve this or you get out of the room and I’m in these meetings and everyone while this is better than doing nothing, I’m like, no.

Mark: 00:53:02 Well I guess wrong.

Mark: 00:53:05 Or just telling kids to eat more fruit is going to cure obesity.

Brad: 00:53:10 Yeah. It sounds like there’s some impure influences into the stories such as the Prophet, uh, influence of building more dialysis machines, uh, making more, uh, prescription medication to address things like, and reminds me of the, I don’t know if this anecdote is, is more rumor than true, but, uh, it was bantered around in the education circles years ago where, um, the state of California would, uh, analyze third grade reading test scores and project the, uh, construction of new prisons according to the rise or fall of the test scores in third grade. Predicting that if the kids aren’t reading at third grade level, they’re going to have real trouble. They’re going to bomb out in high school and have more likely to be incarcerated. So it’s pretty horrifying story, but it’s playing out in, uh, you know, the, the growth of the prison industry and the decline of the emphasis on education. Then we go over to the food side and, uh, w for some reason we still have entrenched in conventional wisdom today. Like you say, I don’t know if WeightWatchers change course, but it used to be zero points to consume your fruit. So you could go all hog wild on fruit and still qualify

Mark: 00:54:24 on them before you know, publicly that, you know, I mean really they, these folks should be called for high crimes and misdemeanors. So the sell, there was a great article, we could link it, Brad just, I think it was yesterday, the Huffington Post just posted an amazing thoughtful article called “Everything You Know About Obesity is Wrong.” And what it really points out is society’s view of obesity in this fat shaming. Kind of like when we spoke in the beginning, you know, we’re one kid out of your class of 30 is failing. You know, maybe it’s about that kid, but when two thirds are failing, you know, it’s not about the kid, it’s about something else. So you know these programs, you know, we’ll cheer people who can suffer the most and starve themselves. It’s the most, you know, it’s all about their individual willpower. But the biology of what these programs throw out to the insulin resistant patient is complete garbage. It’s a great business model. So if you buy their packaged foods, restrict calories to a thousand a day and starve yourself and be miserable, you will lose weight. And the WeightWatchers meeting, we’ll cheer you on as the most powerful person in the room because you, it’s a workout. So I, when you showed up for your Tuesday run that you talk about, was that the day that we could did the run and was Tuesdays,

Brad: 00:55:38 Tuesday run in San Diego with a

Mark: 00:55:41 the most pain on their body, and then that would be the rock star. The week. They’re like Brad man. You would just, you know, you were on today, man. You just lay the hammer down and you just dropped everybody. Good on you. Dude, but that’s like a WeightWatchers meeting. Know no offense to Oprah. She got ladies out running and I love that Oprah empowered women to go run because she finished the Marine Corps marathon and the next day every woman in America said, I can do that. So you know, hats off to you, Oprah for the getting women out running. But the business model of any of these ideal protein shake ology that if it involves calorie restriction to starvation levels, it’s not healthy. You mean that’s how we are or people and I, it’s, it’s inhumane because people go spend their money,, they leave these programs because they all gained the weight back and they’re feeling like they’re the failure because the program will say, well, just get back on the [inaudible]. You shouldn’t program, you’ll lose the weight again. It’s not our program’s fault. You lost the weight when we restricted you to 800 calories.

Brad: 00:56:45 Yeah. Speaking of that, uh, Vinnie Tortorich fitness confidential guy who, who comes clean and he’s the straight straight shooter, if nothing else, man, but he properly called out. Uh, he called out Oprah Winfrey because she, this is a I think five years ago or something where, um, she, she got fat once again, you know, she’s been up and down for it, for the public eye to celebrate and then a [inaudible] and then you know, another progress. But at one point she invested heavily in WeightWatchers. That was a big story cause I think WeightWatchers was running out of money and she became a big investor. And then, uh, you know, went back into uh, one of her weight loss modes and he called the hypocrisy there because, um, it, it’s kinda kind of ridiculous when this is our, our health fitness weight loss role model. Um, and I like to connect that right over to that, um, comment you just made about the Huffington Post article and Gary Taubes, who said this so beautifully, uh, back in his book, “Why We Get Fat.” He said, it’s not your fault. And what he meant by that was that this metabolic disorder that you get into a, a little bit of the science here on the show where we have this high insulin production. And then it throws everything off where we can’t burn fat anymore and we truly are hungry for more quick energy carbohydrates because our metabolism is so screwed up. And if you’re hungry and you’re a human, you’re going to go eat. And if you’re tired and don’t have the energy to get off the couch and work out, you’re not going to get off the couch and work out because you literally are tired. You don’t have energy in your bloodstream.

Mark: 00:58:16 Yeah. Everyone who’s listening to this, if you’ve not read, you could pick up the cliff notes version, which is “Why We Get Fat and What to do About it,” which is the 200 page drill down from the 450 page. “Good Calories, Bad Calories”, you know, get it on audible and listen to it. And it’s just an amazing work. You know that that was a well over 10 years, you know, I know Gary well and he came to West Virginia and, and spoke to at a state public health conference and just, you know, he’s like making the case, right? It’s like you’re in a court of law. All you can do is lay down the evidence and let people, let the jury decide, you know, if he’s right, then we have it all wrong. You know, if he’s wrong, then keep doing what we’re doing. So I think he’s right.

Brad: 00:58:59 Yeah. Well that’s a good, that’s a good combat mark because whatever side of the debate you’re on right now, and if you’re a low fat, a grain-based diet or you know, plant-based, whatever you want to call it, you’re going to be consuming a lot of carbs for your energy. Um, we have to look around and see the disastrous results. So something that we’re doing now, it, you know, the food permits been around since the 70s and by and large people have strived to adhere to that and possibly done a decent job. But then we go back to, you know, the, the comments, uh, of Gary Taubes and in the, the recent article that you’re doing the best you can, but you’re hungry at 10:45 AM after your breakfast of oatmeal, orange juice, toast with jam and something, something doesn’t smell right about the story.

Mark: 00:59:50 And we’ll see what happens in 2020, Brad, every five years. The, I’m involved in a group called the Nutrition Coalition, you know, led up by Nina Teicholz, Dr. Sarah Hallberg. So we’re not advocating for any one specific kind of diet, but all we’re advocating for is to open the book of scientific evidence when we develop US dietary guidelines for an entire population. You know, so there’s a whole body of evidence that that group has ignored. And last year they made some baby steps, not last year, 2015 they said this sentence in the u s dietary guideline scientific page where they said fat and cholesterol are no longer nutrients of concern. Like, what the hell does that mean? That means that basically they’re back on the table and they said, yep, there’s no limits on eggs. There’s no limits on fat. They still limit saturated fats. I’m hoping that one will go away, but they basically, you know, uncapped, any limit on fat or cholesterol, they, but they can’t come out and say they were wrong.

Mark: 01:00:46 I’ll all government agencies do. And you know, medical establishments, like the American Heart Association, you know, they’ve raised more money than any nonprofit on the planet. So could you imagine if they came out after accepting all this money and, and having the world put on statens and you know, eating or quote heart healthy diet, you know, which fruit loops have the, the heart healthy check on it? Well, we were all wrong. You know, they’ve just lost all their credibility. So this is the language that they use. We’ve updated our guidelines or we’ve revised our guidelines, which were the guidelines they created. You know, so, I mean, I admit I was dead wrong like 10 years ago. I was probably the doc in that article, you know, that’s in the Huffington Post today.

Mark: 01:01:24 Maybe I didn’t say it overtly, but if a patient came into my office who was 300 pounds, I probably had a bias that, well, you know, look, I’m not, I’m a skinny, you know, I’m a runner. 01;01Why don’t you just do what I do? No, I eat all this carbs and I’m fine. But that wasn’t it because I was an evil person. I just didn’t understand it. And now the first thing I say to a patient, Brad, is overweight as the first thing I say, let’s just get it off the table and I’m glad the article, we’d have to link that one. It’s open access, but I say, look, you’re here, you’re overweight. It is not your fault. Trust me, it is not your fault. This is obesity is not an energy balance. It’s not because you’ve eaten too much or you have no willpower. Trust me, I understand. You don’t have to explain it to me. You’ve tried everything. It is not your fault. And then once you get that out, like no, I mean people will cry because just before you can have a conversation, as long as they know you’re not judging them and you understand what they understand because these people know they are not lazy and gluttonous.

Mark: 01:02:25 I mean these are hard ass working people and they know it’s not their fault, but just to hear it from a healthcare provider before you even discuss anything else. Look, it’s not. It’s like, you know, an alcoholic walks into there and look, I know this is not, this isn’t your fault, right. You know, your genetics, your environment, like it just shit happens. It’s not, you’re not weak. You know, somebody gets hooked on opiates because the doctor prescribed Percocet after they spring their ankle. Right. That is not the patient’s fault. You know, they, that’s the Chemical Bang in the brain. So we just need to do that across the board. Just, you know, rid the guilt that the patient has and start clean.

Brad: 01:03:04 I mean, in your experience as a physician, do you see that, uh, that negative attitude and that’s self-defeating. A disposition come into play when people have tried, failed, struggled and then they feel like they are lazy and undisciplined rather than that they have a metabolic disorder.

Mark: 01:03:24 Yeah, all the time. I’ll just share my, this patient who was assaulted, uh, today, today’s, uh, Thursday, Tuesday I was in clinic and I saw a young man who’s 30, and I saw him a month ago. I’m not sure how. I have a low carbohydrate clinic and somehow he found my clinic first visit, 425 pounds. Um, you know, pretty standard, you know, guy otherwise, wow. Other than the supporting 25 pounds, which isn’t gonna, he won’t be well for long, his joints were hurting and we just went over the basic food paradigm of just, you know, Vinnie Tortorich right. And S and G, you know, fitness confidential, no sugar, no grains, you know, just do this for a month. And he has no way to even weigh himself. He weighs 400 pounds. So he comes into the clinic on Tuesday. How you doin, Man? I think I’m doing okay.

Mark: 01:04:10 I don’t, you know, and I as clothes are fitting a little better. He steps on the scale is 395, you know, in four weeks, that’s 30 pounds out a day. But what he said was profound and I see it a lot. He’s like, because he hadn’t been weighing himself. He can’t, there’s no home scale that’ll do that. He, it’s like, wow, you know what doc? I wasn’t hungry and that says it all right there. He wasn’t hungry so it gave him hope. No, he’s not counting anything. He’s, but he’s got a long way to go. And you know, if he goes off the wagon so to speak, you know, he goes out with his buddies and drinks beer and has pizza. At least he knows there’s a wagon he can get back onto. And that’s, if people have hope that they can get out of it then, then they have hope.

Mark: 01:04:56 If there’s despair, despair is when you have, you’re helpless. Right? And we see all this, we see this with all these obese patients who’ve spent their whole retirement. I mean the, I’m not making this one up too. It’s, it’s a, there’s more money spent in this country on weight loss than national defense, which blows your mind, right? Like she’s always look were bomb in the world. More money spent on weight loss in the most. We’re not the most obese country. The Middle East is more obese because they’ve adopted our lifestyles and you know, they stay inside all day cause it’s 150 degree. That’s kind of a sad statistic.

Brad: 01:05:34 Uh, back to the blood tests. You, you recommend the coronary calcium score and we talk about this uh, epidemic condition of high insulin, chronically high insulin hyperinsulinemia but you don’t hear a lot about uh, blood testing for insulin values. I, I know there is a blood test for insulin, but it doesn’t seem like it’s a prominent marker. Can you explain what’s the deal there?

Mark: 01:05:58 Yeah, it’s not an easy one to get and there aren’t good protocols. I’m actually working with a gentleman now in the Netherlands called Eric Smith. He has a company that has a point of care, insulin tests. You know, for me, I mean most of the time you explain it to people you don’t need that if they’ve got weight in the middle, you just get rid of the carbs for a month and see how it goes. Your body will tell you if your insulin was, if you respond to that diet, like the gentleman I just described, that’s his ticket out. All right? He’s eating to satiety. He’s getting full proteins, full fats. He’s not doing a vegan cleanse or something. You know he’s eating a sustainable diet for life. You know, pretty much like any ancestral diet. But if people kind of want to catch things earlier, just need a number to convince them. What I would suggest to them, and you can get it, it’s called a glucose tolerance test, but you would do it with insulin. So you are drink 75 grams of glucose. Now, glucose is different than soda, so does a mixture of glucose and fructose. But so those, if there’s ladies out there who did that test during pregnancy, it’s really nasty. So glcose can be utilized and absorbed quickly and can be utilized by every cell in your body.

Mark: 01:07:07 A fructose needs to go through the liver first. So fructose doesn’t raise your blood glucose as fast as white bread, which is glucose or a pure glucose drink. So you can measure at an hour after 75 grams of glucose and see what your insulin is. If people want to read about it. There’s a book by Dr.Joseph Kraft who just died this year at age 96 called “Diabetes and You”. and he said this, find me a patient with cardiovascular disease that does not, I’m sorry, find me a diabetic who doesn’t think they have cardiovascular disease and I’ll show you they’re undiagnosed. Cause what he, he he found was this condition called diabetes in Situ 2. Meaning they’re not full blown diabetes yet, but they have these high insulin levels and they also had cardiovascular disease. He was a pathologist and he based that off of about 4,000 autopsies with these glucose tolerance test. So he made a direct correlation to high insulin levels. And the cardiovascular disease, which is basically diabetes, he said diabetes is cardiovascular disease. It doesn’t cause it is it? It’s the same damn thing driven by insulin, which is a growth factor in inflame or of the blood vessels. I don’t know if that got too technical, but

Mark: 01:08:20 That’s a great book. It’s a paperback published in 1976, Joseph Kraft. And you can just Google Kraft Kurves. Hey, K, R A, F, T, and you’ll see, wow. Um, I’m trying to get one of those machines for my clinic. You know, just like a glucometer, right? Do a finger stick and you see what your insulin is. And then, you know, you could say, well gosh, that French Toast is not a good idea cause your insulin like shoots through the roof.

Brad: 01:08:46 Well I guess for the non-scientific approach, you can, uh, assess whether you’ve been accumulating excess body fat over the years and decades, uh, routinely. And you can assess whether you have an energy dip after a high carbohydrate meal and know right there that you’re in sort of, hey, you’re here in a, a a warning red flag state. And that’s not how life should be lived.

Mark: 01:09:14 Yeah, I don’t think, I think some people want numbers, objective numbers are good for research, Brad. But as individuals, they, you know, if whatever, this is kind of how I explain it to people too, is what you’re doing working for you? And they’re like, well no, well let’s try something completely different. Right? So if they’ve been doing, you know, this, this, this, this and this not working and what have you ever tried Atkins diet? Have you ever tried low carb diet? You’ve ever tried to ketogenetic diet, you know, whatever, let’s just try it for three weeks. You know, like obviously you got nothing to lose cause all these other plans, he’s gained the weight back. And you know, not everyone responds to that. I’m not thinking the world needs to eat this way. But if you were to look at the data on people that are obese, diabetic, insulin resistant, if you were to look at a first approach that’s based on human physiology, that would be your approach. It shouldn’t be shocking, you know, even to a nonmedical person that if insulin is driving the problem, have a diet that doesn’t, you produce too much insulin, at least

Brad: 01:10:14 not everyone needs to eat this way. So maybe a, what about a athletic person like yourself who goes in and, uh, gives the blood values and the, the, the glucose is healthy, the triglycerides are healthy and they’re eating a high carbohydrate diet or these certain genetically, uh, unique individuals that can thrive, uh, with a little bit of extra or a lot of extra carb intake for whatever reason.

Mark: 01:10:39 Totally. This would be, you know, you’d go around the planet, you’ve traveled, these are just healthy societies. The one thing that these, how these societies do not do is they don’t have sugar sweetened drinks and carbage and junk food. So if you’re, you know, traveling around, you say go to, there’s this little country called France, you know, I wouldn’t say they’re low carb. I mean they have carbs but they don’t have carbage you know, there’s no junk. Even the bread would be stale by lunch if you bought it in the morning. Cause there’s no fructose, you know, and they’re walking so, and you know, they, they slow down and eat. So they have all those components of the healthy person bias, right? They, they eat dinner together, they slow down, they’re mindful, you know, they’re not working. How many hours a week do they work in France?

Mark: 01:11:20 You know, we work like 80 hours a week, no night shifts and things. So they’re doing everything right and they eat this type of diet. So, which probably has more carbs than a diabetic here in America should start out with to reverse the disease. So if you’re healthy, whatever you’re doing, keep doing it. But I find it hard to find in my life. Like I see right in my hospital. Occasionally you’ll have a a hundred year old come in, you know, that broke their hip or something. Usually there, you know, something like that. That’s the only reason they’d be in the hospital. [inaudible] well people otherwise you just ask them what they’ve done for their whole life. And it’s all old school. Oh, I bacon and eggs. You know, I’ve never see, I’ve never met a single, a hundred year old who has like cereal for breakfast every day that they just did not read those dietary guidelines in 1980 they just ate what their parents ate and their grandparents ate and they’ve managed to keep their brain function too. You know, that’s there just the human experiment of people living long age, but they’re doing other things right too. These are people that are living a simple lifestyle, you know, out in farm country in West Virginia.

Brad: 01:12:28 Ah, beautiful. Yeah.

Mark: 01:12:29 And Martin may have some bread now. They have some homemade bread

Mark: 01:12:33 Home made bread instead of the store bought. Yep. Big Difference. Yes. Before I let you go, I’ll have to ask you about an extremely important a matter of recent current events and that is our friend Kipchoge running 2 hour and 1 minute Marathon

Mark: 01:12:53 Two hours one 1130 and change. Geez. Well he’s, you know, he is like, I read the New York Times article about him like two days before the race. Wonderful story about Elliot Kipchoge and you know He is like Yoda in the pack. And he had one quote I, which is so profound even to people like that, um, gonna start using it with my medical patients. You know, he’s so well read as the people around him says, he never says the same thing twice. You know, that’s like a sign of wisdom, you know, that probably got friends who tell the same story all the time, but he never says the same thing twice. But he said this, the best time to plant a tree would have been 25 years ago. But the second best time is now. And I can visualize him saying that, you know, sitting there, even some golly, you know, Spartan training camp, you know, up in [inaudible], but well, what an amazing human to pull that off.

Brad: 01:13:49 What a nice tie in back to the discussion of the day, which is to transform your diet and avoid this disastrous, uh, demise by metabolic disease that we’re seeing in record numbers. So, um, if you’re, you know, if you’ve had some white death in your, in your past life, uh, today’s a good data to start and turn around. Um, would you counsel a patient with any, uh, parting words, like be gradual with your reduction of the junk or do you want to go for a cold Turkey approach because the sugar is so addictive, even if it lingers around a little bit, what do you think?

Mark: 01:14:26 And, and I leave that up to the person and the individual and their support system because you don’t want to set people up for failure. So there’s probably like two camps, Brad, that I see in medicine. One is, you know, they don’t have any support system and they’re in the hospital and they just had some major event and they haven’t even thought about low carb or anything and you know, they’re just in a bad, you know, affording food and you just try to get them like Vinny Nsng. So let’s do the basics. Then you have people that come to you in the clinic, you know, who read 16 Keto cookbooks, so those people want all in. So whatever. If they don’t want to do it, it doesn’t matter how much I believe it. So I kind of like, what do you want to go all in?

Mark: 01:15:11 If people want to go all in, I don’t discourage that. Now I’ll say, yeah, go for it. If you know it might suck for a few days, you know, make sure he gets salt and you know, don’t go to McDonald’s, you know, avoid the stuff. But if people want a more gradual entry in, that’s cool too. As long as they’re making forward progress, it’s all good. Just as long as I’m moving in the right direction, it’s all good. That’s all I tell people and I’m there for them. I give all my patients my cell phone, my email, because people need, I think this is what it is, Brad. Like if you go in and try to help someone, if they know you’re committed to them, that’s powerful. So look, I’m going to commit to help you, period. You know, you own it. I don’t own it. You own it. But I’ll commit to help you. And then they know that, oh wow, you gave me my cell phone. So he’s, so I think they kind of own it a little more than if you’re going to, if they know you’re there, but you can’t, you can’t go shop for these folks. They have to understand it and own it and then it sets them free.

Brad: 01:16:11 Love it. Dr. Mark, thank you so much for what you’re doing to the great state of West Virginia and getting the word out to all the listeners. Such valuable information and your, you’re walking your talk, man, you turned your pyramid upside down and uh, still going strong. Going for that sub three hour marathon in your spare time.

Mark: 01:16:32 Yeah, we’ll chat after Marine Corps marathon. We’ll lay it on the line, right. Just go out and have some fun.

Brad: 01:16:39 Dr. Mark Cucuzzella, where do we find you? What’s that best website again?

Mark: 01:16:43 Yeah, so I just published a book, so all this stuff, I kind of, my manifesto, so I published a book is so you can go to the website for the book “Run for Your Life”, book.com. You know, and that has a bunch of videos that we’ve uh, that link from the book. You know, we, we’ve filmed a lot of different exercises, running form stuff, got some videos there that of presentations I’ve done on nutrition. So that’s a good place. My have, I own a minimal shoe store, which sells, flatten minimal shoes Tworiverstreads.com. My personal website is Dr. Mark’s desk.com, which links out to a bunch of places. But um, if any of this interests, you just read the book and you might pick something from that book. They can’t tackle 10 things at once, you know, pick a couple of things in your life to work on. Don’t, you know, I feel pretty good. I mean you’ve, you’ve written books with Mark .Shit that’s writing, running a marathon is easy. Writing a book is in your free time, lack there. I was a disaster trying to do that. So I’ve got it down and I feel good that it’s done and I don’t think I would change anything. So I think it’s, for now it’s, it’s nothing is really since I started writing it, there hasn’t been any new massive discovery that would make me tear chapter out yet.

Brad: 01:17:55 Alright, go get the book Run for Your Life. Thanks everyone for listening. Did Dr. Mark Cucuzzella. Thank you for listening to the show. We would love your feedback at getoveryourselfpodcast@gmail.com and we would also love if you could leave a rating and a review on iTunes or wherever you listen to podcasts. I know it’s a hassle. You have to go to desktop iTunes, click on the tab that says ratings and reviews, and then click to rate the show anywhere from five to five stars. And it really helps spread the word so more people can find the show and get over themselves because they need to. Thanks for doing it.

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