Challenging the Status Quo: Rethinking Chronic Disease with Dr. Robert Lufkin

[00:00:03] [SPEAKER_02]: Welcome to the Unscripted Pharmacist podcast. I'm your host, Kyle Rootser, and today we're joined with Dr. Robert Lufkin who just wrote a book,

[00:00:12] [SPEAKER_02]: lies I taught in medical school. But this is coming from the professor, the man of the institution of UCLA and

[00:00:22] [SPEAKER_02]: USA. They're on this special hill for us, right? You were definitely on this hill where we

[00:00:30] [SPEAKER_02]: looked up to you for all the right answers. And as a radiologist, just though, you started thinking

[00:00:38] [SPEAKER_02]: outside the dark closet, shall we say. And after years of following that conventional medical

[00:00:44] [SPEAKER_02]: advice, as a radiologist you found yourself sick. And you had like four chronic disease diagnosis

[00:00:52] [SPEAKER_02]: and you had young kids, scary, and your own medical advice wasn't working, right? But this prompted

[00:01:00] [SPEAKER_02]: him to reflect deeply on his own medical training. And what he ultimately, and what you ultimately

[00:01:06] [SPEAKER_02]: discovered essentially was that you learned and what you learned and what your talk was wrong was

[00:01:13] [SPEAKER_02]: and it was kind of like you discovered this secret. And there is kind of a secret person behind

[00:01:20] [SPEAKER_02]: all this, isn't there? There's kind of a cool influence that when I hear this, I'm like wow,

[00:01:27] [SPEAKER_02]: this is kind of a major turning point for you, when you met a certain person. All right, but your

[00:01:32] [SPEAKER_02]: book serves as both a warning as well as an educational tool which I really appreciate this.

[00:01:37] [SPEAKER_02]: Okay? And this, because I enjoy reading it as well. But the whole purpose of your book was to help

[00:01:44] [SPEAKER_02]: us all from avoiding the same mistakes that and going down the same road that you found yourself

[00:01:50] [SPEAKER_02]: going down and you've done something about it which is bold and courageous and I'll be honest,

[00:01:56] [SPEAKER_02]: I'm a little jealous because I'm like okay, I've been thinking about I got my clippings together.

[00:02:01] [SPEAKER_02]: I started working on how could I create this book? You've done it for me, especially when you

[00:02:08] [SPEAKER_02]: go into and I love this because I love doing deep dyes and chasing a lot of rabbits. But when

[00:02:13] [SPEAKER_02]: you go into the path of physiology of each chronic disease and the conditions, it really for a lot

[00:02:21] [SPEAKER_02]: of us puts the pieces of the puzzle together. And when you find that out, you had this huge

[00:02:27] [SPEAKER_02]: aha moment and you feel everything starts making sense, all the connections start and your book

[00:02:34] [SPEAKER_02]: is kind of that culmination of all those connections, isn't it? So anyways, Robert, welcome to the show.

[00:02:40] [SPEAKER_02]: I'm so excited to be talking to you as you can tell. I'm... You are up there for me because you are

[00:02:46] [SPEAKER_02]: like, I look up to people like you and meeting someone like this is really cool because that's

[00:02:54] [SPEAKER_00]: a very kind of Kyle, thank you for the kind of remarks and I'm a fan of your program

[00:02:59] [SPEAKER_00]: and it's really an honor and pleasure to be here with you today. So I'm excited about this.

[00:03:04] [SPEAKER_02]: This is going to be fun. Cool, cool. So tell me like okay so man,

[00:03:12] [SPEAKER_02]: you've obviously thought about what the response would be to those people that you've taught

[00:03:22] [SPEAKER_02]: and they're probably looking at you going, what are you talking about? You taught us all this

[00:03:29] [SPEAKER_02]: and now you're telling us something different and this book kind of answers what is it that's so

[00:03:35] [SPEAKER_02]: different and what you... I mean, because people are going to come to you say hey, you taught me wrong

[00:03:40] [SPEAKER_02]: what? Like I want to refund right and you can answer and go hey no listen I got I was wrong. So tell me

[00:03:47] [SPEAKER_02]: how many people have come back to you and how many people have you been able to influence with

[00:03:51] [SPEAKER_00]: this book? Yeah well great question. First of all the yeah obviously the title is very provocative

[00:03:58] [SPEAKER_00]: it gets people's attention and it but it but it but it underscores a basic principle about science

[00:04:06] [SPEAKER_00]: in general and certainly medical education particular and in the book I quote one of the greatest

[00:04:14] [SPEAKER_00]: physicians of all time Sir William Osler who lived at the end of the last century or at the

[00:04:22] [SPEAKER_00]: beginning of the last century and he famously made one of the best quotes about medical education

[00:04:28] [SPEAKER_00]: when he said to he addressed a graduating class of medical students who had just completed medical

[00:04:34] [SPEAKER_00]: school it was on the day they were going to become physicians and he addressed them and famously

[00:04:41] [SPEAKER_00]: said gentlemen and at that time most of them were male which is no longer the case but said gentlemen

[00:04:50] [SPEAKER_00]: we have a confession to make 50% of what we've just taught you in medical school is wrong

[00:04:56] [SPEAKER_00]: and furthermore we're not sure which half it is and that starts it out. Yeah and that really

[00:05:11] [SPEAKER_00]: it's a moving target our knowledge is constantly evolving and indeed the things we were taught

[00:05:16] [SPEAKER_00]: before may not be true anymore and we're constantly refining our view of reality and

[00:05:23] [SPEAKER_00]: that's what this book hopes to do. I mean if I could say point out of you the things the

[00:05:30] [SPEAKER_00]: the misconceptions that I had that I had and that I'd actually taught and sadly many my colleagues

[00:05:37] [SPEAKER_00]: still have and are still teaching about a chronic disease epidemic and you know I like you say

[00:05:47] [SPEAKER_00]: I'm not a conspiracy theorist you know I'm I'm basically part of the problem I'm a I've spent my

[00:05:52] [SPEAKER_00]: whole career in academic medicine practicing medicine teaching doing research I'm one of those

[00:05:59] [SPEAKER_00]: guys who got you know millions of dollars from drug companies to do research and written hundreds

[00:06:05] [SPEAKER_00]: of peer-review papers and and all this sort of thing and I still firmly believe that

[00:06:12] [SPEAKER_00]: Western medicine has transformed our lives certainly in the 20th century all the pills and

[00:06:19] [SPEAKER_00]: surgeries that were developed largely through public health measures and infectious disease but

[00:06:24] [SPEAKER_00]: really everyone in the world today lives a better life because of the breakthroughs of medicine

[00:06:30] [SPEAKER_00]: in the 20th century but I think that the problem is and what the book tries to address is that

[00:06:39] [SPEAKER_00]: in the 21st century the world is different something is happening in fact we're now facing

[00:06:46] [SPEAKER_00]: literally a tsunami of chronic diseases that make up of 80% of medical expenditures and these

[00:06:54] [SPEAKER_00]: chronic diseases are in epidemic proportions that were never before present in history even

[00:07:00] [SPEAKER_00]: accounting for differences in population but and while these diseases were present in the 20th

[00:07:06] [SPEAKER_00]: century they're now just exploding in the 21st century where most people most adults have at least

[00:07:13] [SPEAKER_00]: one of these chronic diseases and and many have have several of them and the problem is

[00:07:19] [SPEAKER_00]: when Western medicine takes those pills and surgeries that were so revolutionary so magical

[00:07:25] [SPEAKER_00]: and they're effect on the 20th century and then just applies them to these 21st century chronic

[00:07:32] [SPEAKER_00]: diseases an interesting thing happens is that for for many of them the pills actually work

[00:07:39] [SPEAKER_00]: addressing the symptoms in other words I may feel better you know if I'm a diabetic my glucose

[00:07:45] [SPEAKER_00]: spikes will go away and I won't die of keto acidosis but the problem is and what we're just

[00:07:51] [SPEAKER_00]: seeing to understand is that these these pills and surgeries address the acute symptoms but

[00:07:57] [SPEAKER_00]: in many if not most of these diseases it doesn't address what's called the root cause and the

[00:08:04] [SPEAKER_00]: disease continues to progress and and by by muting or blocking the symptoms making the symptoms go

[00:08:13] [SPEAKER_00]: away it's almost even worse because then we don't worry about it anymore but the disease is still

[00:08:18] [SPEAKER_00]: progressing and that's the challenge and that's what happened to me and and like you know

[00:08:26] [SPEAKER_00]: like you mentioned I went back to the research in the books and you know on the shoulders of many

[00:08:33] [SPEAKER_00]: giants I learned kind of the revolution that's been going on and there's a way to address these

[00:08:40] [SPEAKER_00]: chronic diseases and it's really not with pills or surgery unfortunately the secret is something else

[00:08:47] [SPEAKER_00]: and it's this the same approach that works for all of them all the way from obesity to diabetes to

[00:08:54] [SPEAKER_00]: hypertension to cancer cardiac arrest heart attack stroke Alzheimer's disease even mental illness

[00:09:02] [SPEAKER_00]: and that list is the list of things that for you and I most of our listeners will be the things

[00:09:09] [SPEAKER_00]: that end our lives those are the diseases that we die of and the interesting thing is when we push back

[00:09:17] [SPEAKER_00]: those diseases using the some of the transformative things that I talk about in the book

[00:09:22] [SPEAKER_00]: we actually improve our lifespan and we we start living longer healthy our lives and that's

[00:09:29] [SPEAKER_00]: what I'm excited about and I want to I want to communicate as it's too as many people as they can

[00:09:35] [SPEAKER_02]: so they don't make the same mistakes that I did yeah this this epidemic really is what we're

[00:09:41] [SPEAKER_02]: suffering like it's non-invincible diseases this diseases of western civilization

[00:09:46] [SPEAKER_02]: and when I say diseases of western civilization I immediately think of Gary Topps

[00:09:54] [SPEAKER_02]: so tell me about how did you stumble upon him and this disease of Western civilization

[00:10:00] [SPEAKER_00]: this exposure to these talks yeah as it turns out Gary Topps is an old friend of mine he lived in

[00:10:16] [SPEAKER_00]: his science journalist a brilliant journalist he's he's written several New York Times bestselling books

[00:10:22] [SPEAKER_00]: on on nutrition and and rethinking basically the metabolic story that that I talk about in one of

[00:10:31] [SPEAKER_00]: his first books that he was working on that I recommend to everyone is good calories bad calories

[00:10:36] [SPEAKER_00]: as a place to start but he has yes several more and they're all they're all fantastic but I used to

[00:10:43] [SPEAKER_00]: I used to pass by Gary in Santa Monica my way to work and he would be you know working

[00:10:49] [SPEAKER_00]: in a cafe at a coffee shop or something you know we we chat a little bit but interestingly

[00:10:56] [SPEAKER_00]: I didn't really pay attention to what he was doing other than he was a nice Israeli friend so it's

[00:11:03] [SPEAKER_00]: not like we hammered out concepts on this his his work predated my my epiphany or our

[00:11:16] [SPEAKER_00]: rebirth about this so I knew what he was doing but I didn't do I didn't do a real deep dive

[00:11:23] [SPEAKER_00]: until I came down with the diseases myself you know I'd like to say oh I was curious and I wanted

[00:11:29] [SPEAKER_00]: to make the world a better place but no I was forced into this when I when I when I developed these

[00:11:35] [SPEAKER_00]: chronic diseases and it was really out of self-interest that I started doing because I didn't want

[00:11:40] [SPEAKER_00]: to die myself right you was scared of death exactly it got me it got me to the same place so

[00:11:48] [SPEAKER_00]: hopefully I could now amplify Gary's message and in many other people in this space you know what is

[00:11:56] [SPEAKER_02]: strange coincidence right such a weird coincidence hey two people right in books just kind of

[00:12:03] [SPEAKER_02]: pass by together just off I several years but like that's so cool because I know Gary has just

[00:12:09] [SPEAKER_02]: that a tremendous influence I mean man this yeah yeah and you you as well this is kind of something

[00:12:16] [SPEAKER_02]: that you felt like you probably needed to do what what was the inspiration of of really through

[00:12:21] [SPEAKER_00]: book you mean yeah yeah yeah getting it right well like I said I you know I spent my whole career

[00:12:29] [SPEAKER_00]: in academic medicine so I've written a lot of textbooks and I've written a lot of like hundreds

[00:12:34] [SPEAKER_00]: of peer-reviewed scientific papers which you know are sort of the gold standard of scientific research

[00:12:40] [SPEAKER_00]: but I realized you know the end of the day nobody read though or anything I mean it was a very

[00:12:46] [SPEAKER_00]: arrow section just by the nature of scientific research there you don't reach what you don't

[00:12:53] [SPEAKER_00]: reach a wide audience and when I when I began understanding what was possible in my life

[00:13:01] [SPEAKER_00]: and what a lot of people my colleagues were not aware about these chronic diseases I realized that

[00:13:07] [SPEAKER_00]: it wasn't a matter of writing scientific papers again because they're actually our scientific

[00:13:12] [SPEAKER_00]: papers that I based my book on so you know this to be clear this is not original research that I

[00:13:19] [SPEAKER_00]: discovered I basically go back to the scientific papers and I reference them in my book so if people

[00:13:24] [SPEAKER_00]: want to they can't look at them but so I realized you know writing one more scientific paper

[00:13:31] [SPEAKER_00]: wasn't going to move the dial so I did something I never done before as I basically started on social

[00:13:38] [SPEAKER_00]: media you know I had 10 Twitter followers that it was called Twitter at the time and YouTube and

[00:13:46] [SPEAKER_00]: and I began writing a book not for not for academics but for regular people so this book is aimed

[00:13:54] [SPEAKER_00]: at everybody you know people the man on the street the woman on the street the kids on the street

[00:14:02] [SPEAKER_00]: it's it's illustrated with a lot of pictures and diagrams like photos of me and my dog and

[00:14:08] [SPEAKER_00]: different stuff like that but also it has references like I say I try to I try to when I make a

[00:14:16] [SPEAKER_00]: claim I try to leave a reference so in the back people who are interested and you know I encourage

[00:14:21] [SPEAKER_00]: everybody to do it although some people may not be inclined to but look at the original references

[00:14:27] [SPEAKER_00]: you know yeah you could read them and interpret them yourself but it also several people have said

[00:14:33] [SPEAKER_00]: this this book is great because they can take it and they read it they like it then they can

[00:14:39] [SPEAKER_00]: hand it to their doctor and because the references are in there the doctor does not want to say well

[00:14:46] [SPEAKER_00]: Rob Luffkin says this or Dr. Luffkin says this well that doesn't mean anything you know expert

[00:14:52] [SPEAKER_00]: opinion is the lowest level of scientific evidence and you know whether my mom says it or I

[00:14:59] [SPEAKER_00]: Dr. Luffkin says it or any other expert we should we should discount those opinions in favor

[00:15:06] [SPEAKER_00]: of peer reviewed scientific research and that's and that's what I try to include in the book and

[00:15:12] [SPEAKER_00]: I encourage everyone everyone to do that and I continually question my own beliefs you know and

[00:15:20] [SPEAKER_00]: constantly look look to refine my view of reality with with these ideas as well right

[00:15:27] [SPEAKER_02]: the the last thing you want some patient that tell you as I believe you I don't want you to believe me

[00:15:34] [SPEAKER_02]: I don't don't even please don't challenge everything go ahead look at it I want you to see it I want

[00:15:41] [SPEAKER_02]: you to lay eyes on it I want exactly let's go through it let's talk about it and like

[00:15:46] [SPEAKER_02]: but you're right the the data is there the study the mechanisms the proof for the mechanism

[00:15:51] [SPEAKER_02]: all of essentially the root cause of chronic disease I guess I guess it's somewhat debatable

[00:15:59] [SPEAKER_02]: you know I you know some people say it's the muscle some people it starts with fat cell

[00:16:04] [SPEAKER_02]: what what's your what's your origin story of metabolic syndrome and this mitochondrial

[00:16:12] [SPEAKER_02]: focused um I don't know cellular biology the the concept of life I think you got to go into it a

[00:16:20] [SPEAKER_00]: yeah we the book talked a lot about metabolism and I believe metabolic dysfunction is it the root cause

[00:16:29] [SPEAKER_00]: of all these chronic diseases if not V root cause but certainly A root cause and this manifests as

[00:16:37] [SPEAKER_00]: things like chronic inflammation insulin resistance and oxidation we talk about how all those things

[00:16:44] [SPEAKER_00]: manifest from metabolic disease and contribute to these these chronic diseases we dive into it

[00:16:54] [SPEAKER_00]: deeply with things like m-tor as a metabolic switch and we even talk about you know certain drugs

[00:17:02] [SPEAKER_00]: like rapomison which can can improve our metabolic health and and even increase our longevity at

[00:17:11] [SPEAKER_00]: in the animal model it's the single single this the most powerful pharmaceutical intervention across

[00:17:19] [SPEAKER_00]: any animal species that's been tried on has a show significant lifespan improvement beyond all

[00:17:28] [SPEAKER_00]: others and even humans are beginning to take it off label for it's FDA approved drug it's it's very safe

[00:17:36] [SPEAKER_00]: but it requires a prescription but we talk about we talk about that and but metabolism is really

[00:17:45] [SPEAKER_00]: is really key it's it's the driver for these diseases and we talk about mechanisms on how that

[00:17:52] [SPEAKER_00]: how that can be I mean diabetes it's very root is a is a metabolic disease you know with insulin resistance

[00:18:00] [SPEAKER_00]: and that drives all the other diseases in this you don't have to be diabetic to get Alzheimer's disease

[00:18:08] [SPEAKER_00]: but they're certainly related this metabolic dysfunction underlying all of them and and most adults

[00:18:16] [SPEAKER_00]: it's the some papers show up to 90% of adults have at least one metabolic marker of dysfunction

[00:18:24] [SPEAKER_00]: and this metabolic dysfunction then will manifest as one or more of these chronic diseases in

[00:18:31] [SPEAKER_00]: other words it's not necessarily a progression where you get fat and you get diabetes and you get a

[00:18:36] [SPEAKER_00]: heart attack and then you die some people are not fat and they don't get diabetes but they get Alzheimer's disease

[00:18:42] [SPEAKER_00]: other people you know may get cancer other people may get mental illness but what I propose in the

[00:18:53] [SPEAKER_00]: cellar like dysfunction underlying all of these basically increases our risk for these diseases and then

[00:19:00] [SPEAKER_00]: then based on our genetics and other factors it may manifest you know up here as cancer or it may

[00:19:07] [SPEAKER_00]: appear as diabetes or it may appear as Alzheimer's disease but I suggest that the root cause and arguably

[00:19:17] [SPEAKER_00]: the way to to treat it in some cases I'm not suggesting to replace Western medicine or that

[00:19:24] [SPEAKER_00]: anybody discontinue their drugs although I was able to discontinue the drugs as I was put on for my

[00:19:29] [SPEAKER_00]: four diseases by using this plan that should only be done in cooperation with the physicians

[00:19:36] [SPEAKER_00]: certainly any prescribed medicines but the interesting thing is it's possible to do this

[00:19:45] [SPEAKER_00]: the other the other wake-up call for me was that these chronic diseases don't

[00:19:54] [SPEAKER_00]: don't appear Western medicine we have certain criteria for each of these diseases and it's you know

[00:20:01] [SPEAKER_00]: for diabetes if you're a blood marker called hemoglobin A1C is beyond a certain point you be your

[00:20:08] [SPEAKER_00]: diagnosis diabetic but before when it's a little bit lower you're not and I used to think as many

[00:20:15] [SPEAKER_00]: people still do that I get the disease when the doctor diagnosis it when they say oh you've got Alzheimer's

[00:20:21] [SPEAKER_00]: you know or oh you've got cancer or something but what real wake up for me is when I now

[00:20:28] [SPEAKER_00]: understand to be true is that these chronic diseases literally all of them that I mentioned

[00:20:34] [SPEAKER_00]: manifest and begin years to decades before the doctor diagnosis them right and if we wait and tell

[00:20:43] [SPEAKER_00]: the doctor says oh you've got cancer or oh you've you've got heart disease you've got having a heart attack

[00:20:50] [SPEAKER_00]: we've missed an opportunity for prevention and and the techniques that I talk about lifestyle

[00:20:58] [SPEAKER_00]: is what we can do even before we get these diseases and I believe and there's evidence to show

[00:21:05] [SPEAKER_00]: we can decrease our chance of getting these chronic diseases or delay them down the line by

[00:21:13] [SPEAKER_00]: by adopting a healthy metabolicly healthy lifestyle before before the doctor diagnosis and these diseases

[00:21:20] [SPEAKER_00]: while we're you know while we're young while we're you know 25 or 30 you know indeed your whole life

[00:21:26] [SPEAKER_00]: this is this is these are not things to do necessarily when when you're diagnosed with Alzheimer

[00:21:33] [SPEAKER_00]: suddenly start although you could do it and that it works for certain things but I'm encouraging

[00:21:39] [SPEAKER_00]: everyone to adopt this healthy metabolicly healthy lifestyle whether you know you have any disease

[00:21:48] [SPEAKER_02]: because that's when it's more powerful so what would you recommend as preventive measures for

[00:21:55] [SPEAKER_02]: your jaw blown say hey and I need to get my annual checkup but we're going to change this up a

[00:22:00] [SPEAKER_02]: little bit what what are you looking for like you and I we love certain types of labs right we know

[00:22:06] [SPEAKER_02]: what they mean and it's how how can the common user just go out there and go okay I want to

[00:22:14] [SPEAKER_02]: get on the right track I'm gonna read this book I'm going to figure out what's wrong with me maybe

[00:22:21] [SPEAKER_02]: we have a got you know high hypertension maybe I don't even have high I'm blood sugar I don't

[00:22:26] [SPEAKER_02]: even think that's even relevant right but I got high blood pressure when I have high blood

[00:22:31] [SPEAKER_02]: blood sugar not I have high triglycerides I have a low HDL and I've got all this weight in the

[00:22:41] [SPEAKER_02]: size is continuingly I'm having to expand and get more belt loops belt holes right because

[00:22:49] [SPEAKER_02]: I'm expanding beyond my borders here and like what would you suggest as I love numbers

[00:22:58] [SPEAKER_02]: because I love to show change so baseline what would you recommend is a baseline approach to

[00:23:05] [SPEAKER_02]: hey I want to get on this kick I'm going I'm going to go meet with my doctor we're going to talk

[00:23:09] [SPEAKER_02]: about exercise when I talk about labs and I want to I want to do this in a safe way what would you

[00:23:15] [SPEAKER_00]: suggest yeah yeah well let me that's a great question before I go in that let me let me say one

[00:23:22] [SPEAKER_00]: of the way my thinking is change you know they're these lab markers as you say they indicate

[00:23:27] [SPEAKER_00]: when we have a disease when they pass a certain threshold and before that threshold we don't have

[00:23:32] [SPEAKER_00]: a disease according to Western medicine you know either you know and either you have diabetes or

[00:23:39] [SPEAKER_00]: you don't and I used to think of diabetes like I thought of most of the diseases you either have it

[00:23:44] [SPEAKER_00]: or you don't you know and based on genetics life style and stuff some people get at some people don't

[00:23:49] [SPEAKER_00]: well there's an interesting study we talk about the book that took a large population of non-diabetic

[00:23:57] [SPEAKER_00]: adults using the framing hand data and the end-hane status some great great population databases

[00:24:04] [SPEAKER_00]: and they show yeah they showed an interesting thing that hemoglobin A1C which is the

[00:24:12] [SPEAKER_00]: one of the main markers for diabetes as we age the hemoglobin A1C goes up and up and up and up

[00:24:21] [SPEAKER_00]: what does that mean well the take home message for me is that type two diabetes

[00:24:30] [SPEAKER_00]: maybe something like gray hair or wrinkles you know in other words part of life if

[00:24:39] [SPEAKER_00]: yeah if we if we don't die of something else first we're on the track for that because our hemoglobin

[00:24:45] [SPEAKER_00]: A1C is going up our inflamation is going up a lot of things are happening

[00:24:50] [SPEAKER_00]: so and if we live long enough and we talk about in the book longevity the the second

[00:24:58] [SPEAKER_00]: the last chapter is all about longevity because that's what happens when you start living a healthy life

[00:25:03] [SPEAKER_00]: people start living longer and there's a revolution in longevity that you know that's a whole

[00:25:08] [SPEAKER_00]: another conversation that you know there's going to be huge huge improvements in in lifespan

[00:25:15] [SPEAKER_00]: but the point is even though I'm not diabetic now or I don't have Alzheimer's now or I don't

[00:25:25] [SPEAKER_00]: have you know you name it of these chronic diseases it's best if I assume that I'm on the path for them

[00:25:34] [SPEAKER_00]: and I should begin to do this healthy lifestyle right away you know and you're following my

[00:25:43] [SPEAKER_02]: not this it's not this I caught this disease it's not I caught this no I've been progressing and moving in

[00:25:49] [SPEAKER_02]: this slow infinitely like non sensible direction towards this disease that if you think about

[00:25:57] [SPEAKER_01]: the intervention that fixes that is what 30 minutes of the

[00:26:03] [SPEAKER_01]: changing how you're doing right yeah like it's a small intervention

[00:26:08] [SPEAKER_00]: and deeply feel better too it's not it's it's not just delaying chronic disease I mean I

[00:26:14] [SPEAKER_00]: I feel much better than I do I don't have brain fog all these other things but but yeah the

[00:26:20] [SPEAKER_00]: the point is and we talk about this in the longevity chapter when people die of when people die

[00:26:27] [SPEAKER_00]: what determines their longevity eventually we all die right so we die of something but

[00:26:34] [SPEAKER_00]: there's a people think of longevity and aging is just wearing out you know eventually we wear out

[00:26:40] [SPEAKER_00]: like my shirt wears out my shoes wear out my car wears out everything wears out right we wear out

[00:26:46] [SPEAKER_00]: well living organisms don't work that way and they're you know our our our germline cells you

[00:26:52] [SPEAKER_00]: know sperm and eggs don't wear out at all they they're immortal and there's even a mortal species

[00:26:57] [SPEAKER_00]: of animals like the the mortal jellyfish we talk about in the book so it's not that we

[00:27:02] [SPEAKER_00]: were out instead we die of one of those chronic diseases that I just mentioned and the ones

[00:27:08] [SPEAKER_00]: that are exploding now so when someone dies of a heart attack it's not that they're there

[00:27:14] [SPEAKER_00]: heart wears out they specifically have this specific disease so the point is we're all on a path

[00:27:21] [SPEAKER_00]: we're going to get one of those diseases we're going to die of something and statistically

[00:27:25] [SPEAKER_00]: statistically it will be a short list and the list is heavily weighted towards those chronic

[00:27:30] [SPEAKER_00]: diseases you know the top ones are heart attack stroke cancer Alzheimer's disease you know

[00:27:37] [SPEAKER_00]: and those are the chronic diseases that we can influence with with our lifestyle so

[00:27:43] [SPEAKER_00]: I would recommend then when I'm recommending this book is the people embrace the healthy lifestyle now

[00:27:52] [SPEAKER_00]: even even if their labs are completely normal but but most people well backing up

[00:28:01] [SPEAKER_00]: you ask the question what what a normal values and I my answer is well we don't want to

[00:28:08] [SPEAKER_00]: have normal values in our labs because most Americans I mean go down the list 50%

[00:28:14] [SPEAKER_00]: Americans have high blood pressure high retention most Americans are either overweight or obese

[00:28:19] [SPEAKER_00]: you know prediabetes diabetes so we don't want to be normal and and the values that are

[00:28:25] [SPEAKER_00]: that our physicians have based on labs are oftentimes usually normal values you know

[00:28:32] [SPEAKER_00]: your above that you know below that instead what I propose are optimal values ideal values we should

[00:28:40] [SPEAKER_00]: shoot for so you know instead of a fasting insulin of less than 20 is normal I'm not good it should be less

[00:28:48] [SPEAKER_00]: fine I believe you know and but yeah because those those lab markers that they're commonly

[00:28:56] [SPEAKER_02]: putting in in the in the brackets this is your range I mean that's that's based on you know

[00:29:02] [SPEAKER_02]: the population that they're testing and so these these numbers as you know because taught in

[00:29:08] [SPEAKER_02]: medical school too these numbers have gone up like what's what's a normal you know

[00:29:13] [SPEAKER_02]: a liver function test right as well as what's what's a normal triglyceride level right

[00:29:22] [SPEAKER_02]: even I have different numbers like what's optimal hey man I want to get my my HDL my good cholesterol

[00:29:28] [SPEAKER_02]: because you want to call it as high as possible how am I how am I going to do that right yeah and the

[00:29:34] [SPEAKER_00]: in the levels in the healthcare system for like diabetes you he McLeod but anyone see 6.5 above

[00:29:41] [SPEAKER_00]: that you can you then classify the patient as a diabetic you can start billing for diabetic charges

[00:29:48] [SPEAKER_00]: you can start prescribing things below that it's not but if you have you know if you have 6.4

[00:29:56] [SPEAKER_00]: you're still you're still normal you're actually pre-diabetic but but let's leave that for now

[00:30:03] [SPEAKER_00]: you're you would be you wouldn't be called a diabetic but you don't want to be there you

[00:30:09] [SPEAKER_00]: want to be way lower you want to be down by five if you can you know it's like you're pregnant

[00:30:15] [SPEAKER_02]: right you're pregnant something's going to happen nine months from now okay your 6.4

[00:30:22] [SPEAKER_02]: like what direction like why do we get so stuck on these numbers and these diagnosis I've

[00:30:27] [SPEAKER_02]: gotten in major five so people just say hey it's just the number on a line where are you

[00:30:32] [SPEAKER_02]: on that line let's push you way over here on this line right let's stay away from that but

[00:30:39] [SPEAKER_02]: but it's also now with now that we have more information with this new technology with the CGM

[00:30:46] [SPEAKER_02]: continuous glucose monitoring it's like wait a minute an average isn't telling me much anymore

[00:30:50] [SPEAKER_02]: I want to know what is your time and range how much are you varying right which we talked about

[00:30:56] [SPEAKER_02]: mental illness and Alzheimer disease and these massive fluctuations in blood glucose right

[00:31:01] [SPEAKER_02]: and creating this these mood disorders and mental illness can you imagine if the world could

[00:31:07] [SPEAKER_02]: embrace that is that the reason that they're feeling the way they're feeling is because of the

[00:31:13] [SPEAKER_00]: rollercoaster ride they're on absolutely and and you mentioned one thing I just want to shout out

[00:31:19] [SPEAKER_00]: for the first time in history CGMs continuous glucose monitors are available in the United States

[00:31:26] [SPEAKER_00]: as of a couple weeks ago still on the counter without a doctor's prescription so you don't need

[00:31:32] [SPEAKER_00]: to go to your doctor anymore to get them because a lot of doctors would refuse to prescribe them they

[00:31:37] [SPEAKER_00]: you know for all sorts of diabetic exactly and so two companies one one is one is

[00:31:46] [SPEAKER_00]: Abbott and and and the others dex calm they're the leading manufacturers of them but they

[00:31:52] [SPEAKER_00]: have these consumer versions you can go their website stelo s t s t e l o or lingo l i n g o i'm wearing

[00:32:00] [SPEAKER_00]: both of them now really order them yeah yeah comparing them but uh you can just order them and it's

[00:32:08] [SPEAKER_00]: like a it's like an engine gauge on your metabolism you can see what foods spike your glucose and to be

[00:32:15] [SPEAKER_00]: clear glucose spikes are not you know there things to be avoided ideally to be metabolically healthy so

[00:32:23] [SPEAKER_00]: but it's not just foods that spike your glucose you can have an argument with uh with a you know

[00:32:28] [SPEAKER_00]: your co-worker that could spike your glucose other factors can do it too so it's a great great insight

[00:32:34] [SPEAKER_00]: that but yeah also I love that about go ahead and pace them with a bad dream and it's a spike term

[00:32:42] [SPEAKER_02]: like oh you doing she's like I it was up for like four hours in the middle and I'm like what

[00:32:48] [SPEAKER_02]: happened last night and she's like oh I had a dream of someone stabbing me and I was running the whole

[00:32:54] [SPEAKER_02]: night trying to run away from somebody's like what I watched before I go to bed really affects my

[00:33:00] [SPEAKER_02]: blood sugar throughout the evening and like oh my gosh but it was it's cool when you can correlate

[00:33:05] [SPEAKER_02]: your lifestyle with something that's measurable and something that you can learn from

[00:33:10] [SPEAKER_02]: because you're obviously learning like crazy because this must be the real game change or

[00:33:16] [SPEAKER_00]: few because of what's from me yeah yeah no I love them and I wanted I wanted to reach back

[00:33:23] [SPEAKER_00]: to a comment you made about about mental health and anxiety and and one of the chapters in the

[00:33:32] [SPEAKER_00]: book is about mental illness and there's been you know you may have had on your program there's

[00:33:38] [SPEAKER_00]: a revolution and our understanding of of psychiatric disease then like schizophrenia and

[00:33:46] [SPEAKER_00]: and manic depressive disorder and shout out to Chris Palmer and George Eid is really both written

[00:33:54] [SPEAKER_00]: great books on this but they they basically they did a fascinating thing at Chris works at Harvard

[00:34:03] [SPEAKER_00]: hospitals in McLean he's a psychiatrist he deals with institutionalized people with severe mental illness

[00:34:12] [SPEAKER_00]: and he noticed and another people noticed too that that epilepsy the drug for epilepsy overlap

[00:34:20] [SPEAKER_00]: with the drugs for schizophrenia and mental illness there some of the same ones work and then then it

[00:34:26] [SPEAKER_00]: is noticed that epilepsy response to metabolic treatments in other words a metabolically healthy

[00:34:34] [SPEAKER_00]: lifestyle can reduce epilepsy and reduce seizures it's one of the earliest treatments for seizures

[00:34:40] [SPEAKER_00]: is to go into ketosis and that works so they they raised both of them and now this has been

[00:34:47] [SPEAKER_00]: repeated at Stanford independently in many hospitals now are redoing us but they they began

[00:34:53] [SPEAKER_00]: taking their patients and putting them on a metabolically healthy diet just like we talked about in the

[00:34:58] [SPEAKER_00]: book a metabolically healthy lifestyle but specifically with diet and put them into something called

[00:35:05] [SPEAKER_00]: ketosis which is a healthy metabolic state and what they noticed was that in Chris they both talk

[00:35:12] [SPEAKER_00]: about it in their books but I was talking to Chris about it and he had he it works for some patients

[00:35:18] [SPEAKER_00]: not all patients by any means but some patients it's revolutionary in other words one patient went off

[00:35:25] [SPEAKER_00]: all psychiatric medicines and returned home to his family got a job and returned to society

[00:35:34] [SPEAKER_00]: just by doing these metabolic interventions with nutrition and I I always feel the story I ask Chris

[00:35:41] [SPEAKER_00]: I say well Chris you know that's that's wonderful but how do you know it's the diet you know how do you

[00:35:46] [SPEAKER_00]: know it's the the ketosis the metabolically healthy diet I mean maybe it's something else going on

[00:35:53] [SPEAKER_00]: you don't know he says well one of my patients bill who is has schizophrenia which schizophrenia

[00:35:59] [SPEAKER_00]: as your audience may know is a psychiatric condition that's characterized by voices you hear voices

[00:36:08] [SPEAKER_00]: talking to you and that's that's unlike almost any other disease but he basically got out of the

[00:36:15] [SPEAKER_00]: hospital got off all psychiatric medicines went home to his family got a job and I said Chris but

[00:36:21] [SPEAKER_00]: how do you know it's the ketosis he says well it's easy bill tells me he knows that when he eats junk food

[00:36:29] [SPEAKER_00]: which which takes him out of ketosis or if he's strained in the diet the voices start talking

[00:36:35] [SPEAKER_00]: to him again and then he immediately goes back into ketosis and they go away so where are the

[00:36:41] [SPEAKER_00]: voices what is making those choices like okay but yeah exactly exactly but to your point it

[00:36:51] [SPEAKER_00]: it raises a great question I mean most of us thankfully don't have clinically diagnosed psychiatric

[00:36:56] [SPEAKER_00]: conditions you know we don't have that very dear mental illness but I would submit that all of us

[00:37:02] [SPEAKER_00]: I certainly do you know deal with the stress the anxiety the pressure of dealing with my spouse my

[00:37:09] [SPEAKER_00]: kids my co-workers my boss my employees that that you know we go up and down with anger and stress

[00:37:18] [SPEAKER_00]: and frustration and you can't help but wonder if this if this junk food which is basically

[00:37:23] [SPEAKER_00]: which is driving a metabolic gli unhealthy lifestyle if switching to a metabolic healthy life

[00:37:30] [SPEAKER_00]: wouldn't for some of us make our our own mental health much better if junk food can make these

[00:37:37] [SPEAKER_00]: people crazy and Harvard what's it doing to our kids you know and everybody who's basically

[00:37:44] [SPEAKER_00]: everybody's eating junk food all the time today right today's world right can we bring these peaks down

[00:37:52] [SPEAKER_02]: yeah can we can we bring all of these peaks so that they're like really the human body is probably

[00:37:57] [SPEAKER_02]: really designed to see this much sugar yeah it's crazy yeah we never dealt with this before

[00:38:04] [SPEAKER_02]: this is insane of course we're gonna have problems we've never seen this before but what's

[00:38:09] [SPEAKER_02]: interesting is that your healthy lifestyle you're talking about not only you know changes everything

[00:38:15] [SPEAKER_02]: it changes the feeling I think is step one as you feel energized and you start moving and movement

[00:38:21] [SPEAKER_02]: is that really important medicine which always improves insulin sensitivity and glucose never

[00:38:29] [SPEAKER_02]: becomes a problem you don't spike you don't have these huge fluctuations so it's exercise

[00:38:35] [SPEAKER_02]: of course the muscles are feeding the brain this wonderful basically lovely soup for it

[00:38:42] [SPEAKER_02]: BD and F and myocides right and and it's helping you control your fluctuation

[00:38:48] [SPEAKER_02]: then you're moved disorder so movement helps with the brain movement is going to help with your thoughts

[00:38:56] [SPEAKER_02]: for me it was like healthy body healthy mind why this all of this seem to be connected to each other

[00:39:04] [SPEAKER_02]: these aren't just subspecialties of mental illness and cardiovascular like everything is linked

[00:39:10] [SPEAKER_02]: to what I'm my lifestyle but it like it feeds onto better and more goodness through I think

[00:39:17] [SPEAKER_02]: keeping carbohydrates under control keeping glucose under control keeping our insulin in a very like

[00:39:24] [SPEAKER_00]: you say very little less than five yeah yeah absolutely I think all those things play I mean

[00:39:31] [SPEAKER_00]: and with the diet Terry things I think glucose control carbohydrate control is fundamentals so

[00:39:38] [SPEAKER_00]: I eliminate those but also sea doils I think are under appreciated which are industrial oils

[00:39:45] [SPEAKER_00]: they can also drive insulin resistance and inflammation and they're they're particularly hard

[00:39:51] [SPEAKER_00]: because they're in all salad dressing to a lot of hummus and all fried food essentially for the most part

[00:39:57] [SPEAKER_00]: is in sea doils and so it's it's challenging to get those out of our lives but those are

[00:40:03] [SPEAKER_02]: those are important well as well yeah I think people just hey guys hang on hang on it's going to

[00:40:11] [SPEAKER_02]: get easier to do this diet as we have more consumer demand for the right foods and we're able

[00:40:18] [SPEAKER_02]: more of us are able to change our lifestyle it'll become easier to do this because otherwise it's

[00:40:22] [SPEAKER_02]: pretty difficult isn't it it's because you're just bombarded with this garbage yeah I mean it's

[00:40:28] [SPEAKER_00]: it's in everything we everything we eat basically the supermarkets are full of junk food most

[00:40:34] [SPEAKER_00]: of the stuff were served is junk food and and then on top of it we get conflicting opinions from

[00:40:41] [SPEAKER_00]: medical experts we have you know institutions like the American Heart Association that says

[00:40:47] [SPEAKER_00]: sea doils are healthy you know it it's ignoring the fact that the American Heart Association was

[00:40:53] [SPEAKER_00]: essentially funded by multimillion dollar grant from Proctor and Gamble decades ago and Proctor

[00:41:00] [SPEAKER_00]: Gambles and Maker the original sea doil product called Chrisco which was originally a lubricant for

[00:41:06] [SPEAKER_00]: men's submarines but they repurpose it as a food and now you know Chrisco can all loyal

[00:41:14] [SPEAKER_00]: content oil all those all those oils are everywhere but we get we get information from supposedly

[00:41:20] [SPEAKER_00]: trusted sources that in my opinion is not true and harmful yeah and I think in order for people to

[00:41:30] [SPEAKER_02]: get the right information almost kind of have to ignore the advice that their physician I know

[00:41:35] [SPEAKER_02]: that's probably controversial to you what would you tell a future physician today well I think

[00:41:47] [SPEAKER_00]: the key thing is to be aware of these chronic diseases and their basis in metabolism modern

[00:41:55] [SPEAKER_00]: medicine is is siloed in other words one way you can get expertise in in in in in very narrow areas

[00:42:05] [SPEAKER_00]: which is necessary to operate at a high level is to have specialists you know have neurosurgeons

[00:42:11] [SPEAKER_00]: you have endocrinologists you have obstetricians but they can sometimes miss the big picture and

[00:42:18] [SPEAKER_00]: this is a this is a big picture story I mean one thing we're doing on on a bright note as far as

[00:42:24] [SPEAKER_00]: doing that we we've gotten a charity that has agreed to distribute our book to all medical schools

[00:42:32] [SPEAKER_00]: in the United States and we may expand it nationally and hopefully get all medical students

[00:42:38] [SPEAKER_00]: at copy at no cost the publishers waving the fees and I'm contributing the royalties back to

[00:42:43] [SPEAKER_00]: the charity so hopefully we can you know get at least put it on people's radar but this is this

[00:42:50] [SPEAKER_00]: is important and that they need to study it required reading for us in year this is your intro

[00:42:58] [SPEAKER_02]: class right here I love it that is so comforting to hear that is fantastic see you're making a huge

[00:43:05] [SPEAKER_02]: difference I that's talk about an influence the fletitian that are that are looking at and maybe

[00:43:13] [SPEAKER_02]: they're going to find root cause and you're right if they look at all these diseases that

[00:43:18] [SPEAKER_02]: they're learning about from a metabolic standpoint wow what an advantage okay that's fantastic

[00:43:24] [SPEAKER_02]: okay hey I know you want to tell us about um you want to offer us a free chapter of your book

[00:43:31] [SPEAKER_02]: so is that is that still on the table can we still do sure absolutely yeah if people you

[00:43:35] [SPEAKER_00]: know if you don't want to go out and buy the book or get it from your library and without trying it

[00:43:41] [SPEAKER_00]: you can go to my website and download a free chapter but the first chapter you can read it see

[00:43:47] [SPEAKER_00]: if the style resonates with you makes sense and it's both a PDF and an audio version depending

[00:43:53] [SPEAKER_00]: on how you like to consume your media but just go to my website which is Robert LufkinMD.com and

[00:44:01] [SPEAKER_00]: you can download it there and I'm active on social media you know please please say hi I like to

[00:44:08] [SPEAKER_02]: hear it rev you yeah yes no you're on your very active on LinkedIn I love your stuff on LinkedIn

[00:44:14] [SPEAKER_02]: it's excellent it's to the point they're typically pretty cool memes that are pretty funny

[00:44:18] [SPEAKER_02]: um oftentimes making fun of yourself and your own profession as I would but no I really

[00:44:25] [SPEAKER_02]: appreciate what you're doing you're making a huge impact thank you for for being on my show

[00:44:29] [SPEAKER_02]: and I I really really appreciate what you're doing you're making a different thank you

[00:44:34] [SPEAKER_00]: oh thanks thanks so much Kyle I appreciate our conversation it was a lot of fun and I appreciate

[00:44:40] [SPEAKER_00]: also thanks to the work you're doing it's great all right well that's a wrap thank you have a great day guys