Diets: Name-calling VS Obesity

So I did a video recently and it was on
Penn Jillette of Penn & Teller. Penn lost a hundred pounds in 85 days eating
nothing but potatoes. Now you have to ask, well you know, did it create hazards for
his health? He’d lost a hundred pounds but here’s one of the things that came
up. I was gonna show – I have to apologize some what. I was going to show you the
com – one of the comments. One of the fellows, one of the viewers said, I can’t
believe you liked this video, I can’t believe you like this diet.
You said, you dislike this potato diet less than some others so that means
you’re a big fan of it; and I had just gotten through saying I had responded to
his original comment that I’m – I don’t prescribe the potato diet. I’m not a
major fan of the mono diets however, eating is a psychological thing
and Penn is in a whole different space now in terms of his health. A hundred
pounds less, he’s a lot healthier. If the – why didn’t I show those – those comments?
Here was the bottom line. I was planning on it. You know, it’s good
to keep a little spice and debate going on a channel because people can debate
iron sharpens iron. People begin to understand and focus on details but I
had to delete it and here’s why. The guy’s name was “Vegans are Idiots” and I
just couldn’t take that. That’s just – his name was inappropriate in terms of
appropriate respect for others; and besides that I know some a lot of vegans-
Joel Khan for example. Joel can get flippant and hey, you know, Joel can be
job but he’s anything but an idiot. Joel is a very smart guy. So don’t tell me
vegans are – all vegans are idiots and don’t tell me that Penn Jillette is
in worse health than he was a hundred pounds ago. Now I’ll cover a little bit
more about this – this focus; but let’s go back to – to the original – one of the
original points. I did a video a few weeks ago about the biggest diet
mistakes and one of my major points was, yes, we all have our opinions in theories
about diets but food selection, we throw the baby out with the bathwater. We get,
like I said, too much heat not enough light on this situation sometimes. How
did I come up with these? Well hundreds and thousands of patients and actually
supervising hundreds and even thousands of docs, internists, family practitioners
mostly. Mistake number 1: not knowing that you cannot metabolize. Your body
does not metabolize. One of the 3 macronutrients. In other words that you
have insulin resistance, pre-diabetes metabolic syndrome or even full-blown
diabetes. So therefore you don’t know that you have it and you just eat plenty
of carbs and glycemic carbs- rice, pastas, sugars, you name it, fruit juices, sodas.
That is one of the major problems you made. All those bad choices but the
choices weren’t is those choices were driven by your lack of knowledge of your
own body. Nobody’s – most people are not focusing on
whether or not they have insulin resistance and as I’ve shown in multiple
other videos it depends on who you look at but and who you believe but insulin
resistance is very common. So if you believe Jenny Rules for example and some
of the other folks in the diabetes world they would say, by the time our age 60,
half of us have at least insulin resistance. I think that’s way too few. If
you believe the UCLA, University of California in LA, School of Public
Health they would say over half of us by the time were aged 30 have insulin
resistance and a lot of people would agree with that.
Josef Kraft who wrote the book The Diabetes Epidemic would probably say,
even that’s too few and I would agree with him. Those numbers for – that
came out of UCLA showing half over half of adults 30 years and older had insulin
resistance. Those numbers came from looking at a couple of different things;
Hemoglobin A1c and fasting blood glucose. So again, major lack of data there. None
of them are based on OGTT. None of them are based on taking a challenge with any
kind of glucose. None of them are based on an insulin survey.
So again mistake number 1 is, not knowing that you can’t metabolize carbs.
How does it happen? You never looked. You didn’t even get a hemoglobin A1c. Maybe
you did. Maybe you looked at a fasting glucose and you said, well it’s 95 I’m ok,
big problem; but know what that I’ve already done that video. This is a different video and
this is on mistake no. 2. Mistake no. 2 is too much focus diet. Whether it’s carb, keto, paleo,
the 5:2 diet, Jimmy Kimmel’s diet, eating clean. Whatever that means;
and again I’ve studied that. I’ve done videos on it. I still didn’t know what it
meant when I studied it, clean. All of that and not enough focus on BMI or fat
mass. Let’s talk about that for a minute. So back in, you look at this. This was in
CNN December 20th of 2018 and before we go too far down that road of BMI and you
say and look, BMI is a flawed number. I know that. I’ve done 3 videos on it
and this is one of them. Relative fat mass would be a lot better
because we want to look at the percentage of our body fat that is – of
our body that is fat mass. Now, mm-hmm why don’t we do that? Well it’s not easy but
guess what, it’s not easy getting that message across either. If you look over
here, 1370 people viewed it, compared to many thousands
of views for something like my cardiologist said, this was impossible.
Yeah you know I understand, there’s some components of clickbait here but again
we need to begin to understand what’s going on with our individual bodies. And
let’s just go ahead and use BMI because that’s where the – that’s where the – the
big statistics, that’s where the national statistics are coming out and again if
you want to correct me on BMI, go to one of my videos on relative fat mass. This
was again from the lay – lay press at CNN and it was again just late December 2018.
And what it was doing is comparing CDC NHANES studies. NHANES is N-H-A-N-E-S,
National Health and Nutrition Examination Studies. What that study is
doing is documenting the continued increase of obesity in this country. In
fact, the average adult in this country has a BMI over 29 between 29 and 30. 30
is the cut point for Frank obesity, full-blown obesity and the average is 29.
So we’re fiddling while Rome burns. We’re arguing too much about what’s the best
diet and will continue to make assumptions that the best diet for a 20
year old with no insulin problems is also the best diet for someone who’s a
heavy insulin – insulin secretor; and we know, there are people that don’t secrete
a lot of insulin; there are people that secrete a lot and they’re – their –
their body is totally different in response totally different to diets; but
let’s again let’s go back and look at the – the BMI story for this country. So
between 1999 & 2000, and 2015 & 2016, there was yet another significant
increase in the average body weight. Before that, between 1960 and 2002,
there was a 24-pound increase in the average weight of the American Human, 24
pounds. In this one between 99 and 2016, it was about 10 pounds. From – to 197.9
for men, from 189. So, in for women it went from 164 to 170.
So again we’re continuing to get more and more obese. Now this goes on to talk
about the BMI, the formula and again it doesn’t – doesn’t get into some of the
problems with it. If you want to focus on the problems with the BMI that’s for
another video, 3 other videos in fact. If I can remember I’ll put them down in
the description but again here’s where Arden makes the point, one of the folks
from the CDC. The average Americans BMI is now almost 30 which is the cutoff
point for obesity. A normal and healthy BMI is between 18.5 and
24.5 or 24.9. I would say, really the the best in terms of
doing what I do which is looking at heart attack, stroke, cardiovascular
inflammation. It’s not really 25. It’s low 20s- 2021; but the average American again
is 29. So average waist circumference increased as well about a 1 inch in
men, 2 inches in women. Average waist circumference is now 39 in men
and what 30, it went from 36 to 38 inches in women. While height or as weight is
going up, height’s actually going down. They lost a centimeter so mm-hmm
let’s go back. Let’s focus up for a few minutes on this debate. A lot of this
started. I mean it was all about plant-based low-fat until there was a
group that started looking at fat in the diet. Gary Taubes wrote 3 books. He
made most of his literary career so far on this issue of why we get fat and what
to do about it. There’s actually been a lot of folks going in that direction.
These next 2 people are actually very well qualified to deal with this issue.
They are both endocrinologist. This is Robert Lustig. He’s an endocrinologist
that runs an Obesity Center at UC San Francisco. He makes the lecture circuit
talking about obesity and sugar and processed food and how sugar drives
obesity and it has to do with insulin and leptin and hormones. This next guy
David Ludwig, is also not only their name sounds similar, their jobs and their
careers are similar. David Ludwig is also on the lecture
circuit talking about that. He’s a little bit deeper in research. He’s over at
Harvard in the PhD, also an endocrinologist, also running a – an
obesity Center for Harvard and he wrote the book, Always Hungry, that book and the
book by Lustig Fat Chance. Both of them get into some of this hormonal issues
around fat. So basically what they say is – is that they reverse it and I think
there’s a lot of validity to it. Hormonaly, it’s not that we eat more and
therefore we get fat. It’s we get fat and therefore we eat more; and what they’re
talking about is eating carbs or getting insulin resistant – resistance from age.
You start to get these fluctuations in your blood sugar associated with
increased levels of insulin. When you decrease that blood sugar, you
get hungry so you eat. Before you start saying that doesn’t make sense, you
should look into this to the actual research. It’s becoming clearer and
clearer. There are other ways of looking and other people with very strong
opinions about losing weight and diet, how to diet. Dr. Func’s got a lot – a lot
of really good points that you know what, if you just do fasting, it’s cheaper, it’s
easier. There’s – you don’t have to worry about recipes, it’s cleaner etc etc; but
he also focuses on the – the endocrine model for weight loss. So then you go to
somebody like Valter Longo who’s – does a great job in terms of research,
developing good research to support his dietary theories. He actually, he’s not a
low carb. He focuses a little bit more on plant-based, low protein, low fat in terms
of longevity and he also does the fasting mimicking diet proline which is
a 5-day diet where you – the goal there is to kick-start your epigenetics and – and
deal with the problem of epigenetics that we – that many of us deal with in our
60s. Now Valter Longo’s mentor was Roy Walford. He was the father. He was at UCLA
and he was the father of caloric restriction. You’ve probably heard of
that term. You’ve heard specially folks like Jason Func criticized caloric
restriction. Caloric restriction is just chronic low calorie eating so watching
your diet in terms of the amount of food that you’re getting. Longo’s said, you know
his mentor, Doctor – Dr. Walford got some great results on it.
However, he looked like a – a Holocaust survivor and he was hungry a lot. So
he said, that’s – there’s got to be an easier way to do that. Now let’s go look
at the why obesity is an issue. Adipokines. Leptin is the major adipokine
but there are a bunch of them. They mediate inflection inflammation and
insulin resistance. Didn’t know that? Well here. This is TNF alpha. Many of you have
heard of that IL-6, interleukin 6, leptin free fatty acids, other Adipakines. They
have a receptor. When they hit that receptor on the cell wall, that receptor
sets up a whole new set of mechanisms which decreases insulin receptivity. So
one of the major drivers of insulin resistance is obesity. That’s where that
all comes into play and that’s where obesity becomes such a big issue. So to
get back to the – to the issue at hand, we are – here’s – here’s America 2011 obesity
rates. Now, prevalence of obesity rates. Here you see
a lot of green, relatively speaking, not nearly as much green as you would have
seen back in the 1950s because again the average American had gained 24 pounds.
Actually over 24 pounds between 1960 and 2000 but orange is getting higher levels
like 22 what – no 30 and 30%, 34%. Here is the 2017 number. As you see, only
3 states- Washington DC, Colorado and Hawaii are now in the green. The rest of the country is in yellow, orange and deep red
and the orange and deep red have grown dramatically. There are actually now
7 states with an obesity rate greater than 35%. So this
is – it’s huge and it’s continuing to grow. So back to my response to vegans or
idiots, I’m not gonna use that term but I’m tempted to use that term in
describing someone who doesn’t understand the positive health impact of
losing a hundred pounds. So no I’m not a big potato mono diet fan. I don’t
recommend it. However, if we focus way too much on the way we lose weight and not
enough on how much we weigh, we are fiddling while Rome burns. So again
another rant, but I think it’s something that clearly needs to be said. Let’s give
up that we have on arguing about types of diets and first let’s make sure we’re
at a proper BMI. Thank you again for your interest! Thanks and if you hit that
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33 comments

  1. Certainly a whole lot better off losing that much weight. But if you continued a potato diet, which converts to glucose quickly, that would be continuous high blood sugar and inflammation. If it works for losing weight, great, but as a lifestyle choice, it would be self destructive.

  2. There are so many very fat people around now days that it appears to be normal and somebody has to be extremely fat to seem abnormal. I'm 60 and can recall in my younger days that fat people were uncommon, very uncommon.

  3. The reason I like the High Fat (keto diet) is that it removes appetite – I hardly ever feel hungry. (.And got my Natto machine today ($50)…Yay. Will make it easier.)

  4. Calorie counting is Dangerous!! I've done this diet with another – it can become Addictive, I remember it, we ended up almost eating nothing because of fascination of cutting calories. Having done this diet I now understand Anorexia.

  5. I'm going to feel like the weirdo who leaves too many messages on the answering machine. But there's a lot to unpack in this video. So, you'll just have to forgive me for the multiple comments. Otherwise, you'll get one big great wall of text…

  6. Unless you are a genetic rarity, if you eat a standard modern diet, you will develop insulin resistance. The only thing that varies is in which decade of life it appears.

  7. Agree! It would be cool to see a timelapse of weight clusters in the U.S. I think there must be more to the puzzle than just merely food being weaponized.

  8. This is exactly why I trust you and your information. You are balanced. You don’t mind sharing differing opinions and research while including you own. And you are never accusatory of others even while disagreeing. Thanks for the book and research recommendations. They’ve been very helpful.

  9. Perhaps the perfect diet can't exist because the perfect human doesn't exist? We can't benefit completely because we're all destined to age, malfunction and die. The more we enjoy the quicker it happens. God help us all.

  10. I don't know for a certainty whether we can meet halfway, or if this will forever be a point of contention between us and we'll just have to agree to disagree…

    Low-carb is a way to treat insulin resistance (and its many faces, e.g. impaired glucose tolerance, metabolic syndrome, hypertension, diabetes, etc. etc.) I don't believe it's the way to treat insulin resistance. I don't even think it's a very good way to treat insulin resistance. And here's my gripe… If you can't eat a piece of cake or a spoonful of ice cream without your blood sugar going sky-high, you haven't actually solved the problem, have you?

    Imagine you have a friend who's a "couch potato." He has an office job sitting at a desk. He drives to and from work. He always takes the elevator. And he spends all his free time watching TV, playing video games, surfing the net, etc. Just, minimal physical activity. Now, he lives on the 5th floor of his apartment building, and one day, the elevator is out of order. His usual resting pulse is 80 beats per minute. Today, when he climbs 5 stories up the stairs, his heart rate jumps to 150 beats per minute. Now, imagine that he concludes, "Activity raises my heart rate. I need to spend even more time being inactive. Instead of sitting on the couch, I'll spend all my time at home laying in bed to get my heart rate under control!"

    I could give you a dozen examples of (hunter-gatherer, subsistence farming, or otherwise non-industrialized) cultures who eat high-carbohydrate diets, and who maintain excellent glucose tolerance for life. All five of the Blue Zone populations eat high-carb diets. At the very least, one can logically conclude that a diet high in carbs isn't incompatible with exquisite insulin sensitivity or a long health-span.

  11. The problem is that we as a country have been taught that obesity is an acceptable outcome in life instead of calling it what it really is – food addiction. If someone drinks too much alcohol or does drugs, it is acceptable to go so far as to shame this person and look down on them for their addiction. But if someone is obese and has a food addiction, if you try to explain this to the person (without trying to shame them) you could get called out for trying to shame them and everyone will look down at you instead of the person with the problem. It has gotten so bad that it has turned political where the left calls it "fat shaming" and the right uses it in their "freedom" outrage. Not too long ago you had the First Lady of the USA promoting good healthy eating and exercise, and she was attacked for this as being someone looking to steal your "freedom." Then you have someone like the person mentioned in this video who loses 100 lbs and if you voice your opinion on this matter you probably will get labeled as a "fat shamer" who doesn't respect fat people. Am I wrong?

  12. It seems that the best way to maintains one's health while they have it and prevent future lifestyle sickness, is to eat everyday like they are already diseased.

  13. Thank goodness humans can survive on a variety of foods as well as no food for a number of days. We were built to survive, but unfortunately, we are not built to over thrive. Our survival mechanisms are killing us because we never put ourselves in our natural fasting mode. The good news is you, Dr. Brewer, and the other professionals, some of whom you mentioned, are teaching us how a proper body works and maintains health. Thank you for talking about diet and that there is not one that is best for everyone. We all must figure that out for ourselves based on many factors including food preferences. I really enjoy your videos where you bring it down to everyday habits including what we are eating and how we are exercising and a few helpful supplements. Those things are doable and understandable.

  14. Thank you for another balanced and insightful video. I came from a BMI of 29 to 23 over 4 years. I want to stay at this level. I am mostly keto – Almost no sugar or starch, but don't treat diet as a religion. If I am out with friends, I eat what they do. I was shocked yesterday when I had some Japanese Red Bean Cakes and spiked my glucose at 190 – but it came down to 71 within about an hour. I appreciate how much I have learned from your thoughtful discussions.

  15. I personally think what we are seeing is Non Alcoholic Fatty Liver Disease when we see insulin resistance, diabetes, inflammation and obesity.

    The rise in consumption of Fructose and " Heart Healty Oils " is the white elephant in the room being ignored. The whole foods diets from carnivore on one side and vegan on the other side remove these items. Which diet works best for the individual is as much a dogmatic choice as a clinical decision.

    Jon from the iThrive series did an inpatient 40 day water based fast before transitioning to a plant based diet. So for him it took a biblical 40 day fast to purge his glucose reserves and heal his liver to a point where it could function. His decision was to eat plants, convert starch to dietary fat & cholesterol, and lots of exercise.

    Many people, like Kelly Hogan, simply went Zero Carb ( actually nearly zero ) and have their body make glucose. She does not exercise. The same result of a glucose purge and restored liver health occurred.

    The fasting mentioned in the major religions of the East, Middle East, and Western coutures would keep the liver in health. This is Dr. Jason Fung's method. The same idea of Liver healing occurs.

    The Casino and Wall Street would hedge there bet and do all three. Not at the same time or same meal. Mixing fat, protein and carbs produces weight gain. So you cannot eat anything you want.

    So seasonably adjusting diet, fasting, and alternating what you eat based on what you have available. We never had refrigeration and transportation of foods that were not locally available like we have now. We also did not have the carb based, sugar coated, high fructose grain based treats 6 times per day.

  16. Non-related … Merrill F. Unger(1909-1980) graduated from Johns Hopkins University … have you studied his hermeneutical works? You could mention your commonality with your Sunday teachings.

  17. You have the most balanced and fair rants I've ever. . Not angry at all…. just honest.
    Rant on Doc …rant on!!!

  18. When I see videos from the 50s and 60s it's surprising how you seldom see overweight people. I don't think that's because they were more strict with their diets, or that they were more inclined to exercise. The difference I see is industrialized food. What changed?

  19. I can personally attest to the "positive health impact of losing 100 pounds" (2010-11) – and also to the deleterious effect of regaining most of that weight!! (2012-2014) Even with first-hand experience, it's a challenge to stay conscious of our choices, and after overeating for most of my life, new healthier habits are difficult to acquire and sustain. Bearing in mind that the "expert advice" we were given when my DH was diagnosed with T2DM was COMPLETELY WRONG, and that he followed it faithfully for 13 years, I'm beyond grateful that he's still with us!!! We're BOTH working on our blood glucose now; my latest A1C was 5.7 and thanks to you, Doc, I know I've got a LOT of work to do, as that A1C number translates into a much higher average blood glucose than what I NOW know is healthy! ♥

  20. Good video Dr Brewer. Do you know if their is any studies on how much obesity is costing our healthcare system per year?

  21. Potatoes? Why does he hate 'merica?
    BMI sucks.
    I lift weights. My work-provided Dr put me down as OBESE on my report to my insurance. "First do no harm?"

  22. 7:20. You need to headline your video "Kim Kardashian's Butt Reduction". A million clicks no trouble.

  23. I have seen elsewhere that height to waist ratio is a better measure than BMI, where your waist size should be 1/2 (0.5) or less of your height.

  24. Here is another condition that can perpetuate overweight: Excessive cortisol secretion from the adrenals. One reason obesity is increasing is because we are eating the meat of animals that were intentionally being made fat. Whatever was used to fatten the livestock before slaughter also fattens us when we eat meat from the livestock.

  25. Another great video Dr. Brewer. I think your easy going manner is a big plus in dealing with "unkind" comments. I suppose when looking at the potato diet, the health benefit of losing all that weight is greater than the consumption of all those carbs. Similar to Dr. Walter Kempner of Duke University who was a pioneer in treating diabetics with a "rice diet". Again, his patients lost huge amounts of weight. Thanks again.

  26. Good call on maintaining good conduct w everyone. Funny, I accused you of being a well-mannered southern boy (sorry, person), you are a well-mannered southern person. I complain when my second graders are not ‘nice’ I need knowledge stated in an intelligent and accessible way. Sometimes that means being polite.

  27. Dr. Brewer, on this video, you said you'd be looking at a healthy BMI of around 20. Over the past 9 months my BMI has gone from 30.4 to 26.3 on a well formulated Keto diet (72F/5C/20P). I joined a Gym after 3 months ( at a BMI 28.2 on their Body composition impedance scale showing 19.5% body fat) . Today it shows my BMI is 26.4 with a BF% of 14.8%. I've never been an athlete, but at 64 I'm thinking that maintaining a bit higher BMI with more muscle is better.
    Can you do a video on the relative benefits/ hazards as we age related to CVD vs Sarcopenia and fall risk. Thanks for your contribution to SM in this space.

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