Your waist should be less than half your
height. So half of that string should go
around the fattest bit of your belly.
And this is a really simple test for
everybody at home.
>> I mean, it's not.
>> Yeah, you've just done it. You've
passed. But fat on your belly is more
worrying than fat on your legs or on
your arms. And unfortunately, we've
started to normalize things like the dad
bot without realizing that isn't how
you're supposed to be. And maybe a third
of all the people in the world with type
2 diabetes don't even know they have it.
But every year that you have poorly
controlled type 2 diabetes, you're
losing 100 days of life. And it's
because people don't know the truth
being fooled with the packeting and
advertising.
>> So, let's talk about the food we have on
this table because this is how much
sugar I would have thought was in all of
these things here. Cereal, a potato,
white rice, a banana, and a chocolate
bar.
>> So, now I'm going to give you the
correct figure. The corn flakes is 1 2 3
4 5 6 7 8. That chocolate bar is 7 and
1/2. The banana that's six. And then the
potato is actually
>> Oh my gosh.
>> And then 150 g of boiled rice is
>> Oh, I thought rice was healthy.
>> But each of us has a number of different
health futures. And what I'm interested
in is how do I get you to pick a
lifestyle that will get you the future
you want? Because my job is about
behavior change.
>> The floor is yours.
>> All right. So, off we go.
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it. Let's get on with the show.
Dr. David Unwin, you were named in 2018
among the top 10 most influential
doctors in the United Kingdom. Um,
you've got an incredible list of
accomplishments and you're held in the
highest regard maybe of all the doctors
I've ever had the chance to speak to by
many people that I've spoken to. We were
talking before we started recording
about what's on your mind and what's
been bothering you. And so the floor is
yours. What is front of mind for you,
Dr. David?
>> Well, front of mind for me is the the
idea that each of us has a number of
different health futures. So you have so
in your future uh I don't know there
could be cancer. There could uh be
multiple sclerosis or there could be
many futures. What I'm interested in is
how do I get you to pick a lifestyle
that will get you the future you want?
And I think that's very difficult in the
world now to know what is the best
lifestyle because you've given so much
conflicting advice. And the particular
focus for me in terms of picking health
futures is around young people because
they've got the longest time to make a
difference.
And it's getting harder and harder and
harder to make good health choices in
your lifestyle. It's really hard. I'd
say it's a pandemic
of poor metabolic health. Yesterday in
clinic, I saw two people under the age
of 25 who had poorly controlled diabetes
and one of them was too heavy for me
actually to weigh. And this situation is
completely new. So when I when I was a
young doctor uh and just starting off in
practice, that was in 1986.
Wow. A long time ago, just north of
Liverpool in the practice, I'm still
there now. Obesity was rare and we
didn't have a single case of type 2
diabetes in anybody under 55. Not a
single case. It was quite unknown. And
in fact, type 2 diabetes had a different
name. We've had to change the name
because of the epidemic. Used to be
called maturity onset diabetes. That
meant old people, right? Now we call it
type two diabetes because we have to
include so many young people. It's
really really serious
because people are losing their life
expectancy and I'm witnessing this.
We're all sleepwalking into a metabolic
disaster and the people praying the
greatest price in my opinion are young
people and it's a scandal and I'm
hopping mad really. I think we've
started to normalize
the dad bod, you know, the big tummy and
haha without realizing that maybe that
isn't how you're supposed to be. So that
that's what's on my mind. Young people
and their future and they don't even
know.
>> You say young people there. Yeah.
>> Because they've got the biggest
opportunity to change the trajectory of
their health future.
>> Yes.
>> But for the audiences listening that
might be in their 50s now. Is this
advice also applicable?
>> Absolutely. So, we know from g
government figures, UK government
figures
that for every year that you have poorly
controlled type 2 diabetes, you're
losing a 100 days of life. That's about
a third of a year, isn't it? So,
whatever age you are, if you uh have
poorly controlled diabetes, you're
losing life expectancy. and and maybe a
third of all the people in the world
with type 2 diabetes don't even know
they have it because they haven't taken
a test so they don't know. What do you
think kills people with type 2 diabetes?
>> Um is it some cardiovascular issue?
>> Yeah, well done. Well done. you see
you've not been to medical school that
most doctors that's what they say
because we know that a high blood sugar
over time damages your arteries. So it's
a cumulative thing over time. But what
you may not know is that actually
a rising cause of mortality for people
with diabetes is cancer.
>> Oh really?
>> Yeah. So, eight forms of cancer
are strongly associated uh with
diabetes.
>> I want to just define that term diabetes
because I think I went through a lot of
my life assuming that diabetes was a
disease that some people are born with
and because I didn't have it, I thought
I don't need to worry about that.
>> That's really important. Yeah. So, first
of all, there's type 1 diabetes and type
two. But before I can explain
about diabetes, I need to explain about
insulin. This is absolutely key to our
whole discussion.
So, I've already said that a high blood
sugar damages your arteries. And in
fact, there's work to show that a very
high blood sugar damages the non-stick
lining of your arteries within six
hours.
>> Oh wow.
>> Really quick. It's called the glycoalix,
the non-stick lining. And uh damage is
occurring very quickly. So,
>> I'm going to ask you a really stupid
question. Yeah. When you say high blood
sugar, I get high blood sugar when I eat
lots of sugar.
>> Okay. So, first of all, we're actually
talking about glucose.
>> Yeah.
>> And sugar can mean table sugar or it
could mean many different things, but
we're actually talking about blood
glucose,
>> which comes from lots of foods,
>> which comes from many foods.
>> Carbohydrate heavy foods.
>> Yes. Yes, it does. It does. So, that
that's right. But you have the hormone
insulin to defend you from poor dietary
choices. So the question is, what does
insulin do with the sugar you just ate?
And here's the answer. Insulin, the
hormone insulin produced by your
pancreas gland.
It pushes the sugar and it pushes it out
of the bloodstream inside cells where it
can be used for energy for you to run
around.
But what if you take in uh more
carbohydrate than you need to run
around? Well, then that sugar is turned
to fat inside cells because it's safer
for you to turn that sugar into fat than
it is is to have it damaging your
arteries.
So, I am somebody with type two
diabetes. So, we can talk about me. So,
I had a really heavy biscuit habit. uh I
was senior partner of the practice and
it's stressful and I had patients used
to bring me biscuits all the time as a
gift because they you know they want the
doctor to be happy. So in the drawer in
the top of my desk was packets and
packets of biscuits. So, I'm taking in
more sugar and I didn't run around and
gradually my waist got bigger.
And what was actually happening was as I
took in more sugar than I needed to run
around, my insulin was working to get
rid of that sugar and it was giving me
two things. One, a belly.
>> Mhm. So my, you know, and I thought it's
just middle-aged spread, you know, and
the other was I didn't know, but my
liver was filling with fat and that's um
that is very common now. So we have
well it's a third of everybody in the
developed world has fatty liver. Now
here we got the wonderful props. Let's
talk about these. Great. So fatty liver.
This is the healthy liver here.
And you see the color. Look at this one.
It's yellow. It's the wrong color. And
it's because of fat.
So in that case, like has happened to me
over years, my liver began to fill with
fat
>> because it was essentially overworked
and glucose was being stored there.
>> Yes. So I was taking in too much
glucose.
Insulin was doing its good job of taking
it out of my bloodstream and forcing it
inside cells in my belly but
unfortunately in my liver.
>> Okay.
>> And so there's a progressive laying down
of fat in the liver. So if we look at
actually some proper liver. So this is
the put on your seat belts now because
this is
>> somebody's uh somebody's actual liver.
>> So then that's the normal liver. But
look at this. It's larger.
>> That's a real human liver.
>> Yes, these are human livers. And that's
as it should be. But this, look at this
liver. It's larger. And it's larger
because there's so much fat in it. Now,
the twist in the story is fatty liver
interferes with the good work of
insulin.
So, you develop a thing called insulin
resistance, which means your insulin is
no longer as powerful as it was. It's
beginning to become difficult for you to
deal with carbohydrate and sugar because
your insulin isn't working as well. And
the only way to deal with that is the
next twist in the story.
>> You have to start producing more
insulin.
>> Do you see? Because it doesn't work as
well.
>> Yeah.
>> So your pancreas has to crank up the
supply. We need more insulin. So now you
have two things. You have insulin
resistance. Your insulin isn't working
as well, but at the same time, you're
trying to produce more insulin in the
pancreas. This bits called the long
silent scream from the liver. This is
work by Professor Roy Taylor, a friend
of mine at Newcastle University, and he
pointed out that you you've got fatty
liver for about 10 years. You don't even
know. You wouldn't know that your
liver's gone fatty and yellow like that.
But unfortunately, this is another
twist. Fat is being laid down in the
pancreas gland, the very gland that your
life depends upon producing insulin. And
your ability to produce enough insulin
collapses.
And at that point, you can't regulate
blood sugar anymore. But upstream of
that, you have a problem. You've got
that. But you don't even know. You
You're talking about what's in my mind.
Why are we waiting until you actually
have all the problems of type 2
diabetes? So since 2013,
I've got hundreds of patients and I'm
monitoring the baseline and latest
follow-up. So what happens to them? It's
really important.
And now I have a a huge data set that I
can interrogate and answer questions. So
number one question,
let's think about pre-diabetes. So this
is in the long silent screen.
Well, I can tell you that the people
with pre-diabetes in my practice north
of Liverpool,
93% of them will get a completely normal
blood sugar if they go low carb. 93%
resolution and that will last for years
because I've checked. Okay, how about we
wait for the 10 years and Stephen until
Steven you've got type 2 diabetes and
then you go low carb at that point if I
can get you early I've got a 73% chance
of you having a normal blood sugar let's
wait another few years because you don't
want to give up bread and you don't want
to give up chips and pizza fair enough
I'll wait
but you know if we wait five years you
only stand a 50% chance so do You see it
goes 93 over 70%, 50%. So the chances of
me not needing drugs and be able to do a
good job for you are diminishing. So
really it's a stitch in time.
>> Mhm.
>> And so much of this you don't even know.
You don't even know it's going on.
>> One of the things that shocks me is um
is how little we know about what's in
our food.
>> Yes. You know, because I think we all
know that like biscuits are a food that
has a high glycemic index.
>> Well done.
>> Which is a term that I've learned from
this podcast, which means
>> some carbohydrates are more sugary than
others. And then so that's the glycemic
index. What that is doing is comparing
different carbohydrates with pure
glucose.
>> Okay?
>> So you see pure glucose is 100 and then
other sugars come further down.
But there is there's something better
than the glycemic index and that's
called the glycemic load. The glycemic
load takes portions of food and predicts
how will that portion of food
actually affect your blood sugar.
>> And am I right in thinking the glycemic
load would factor in the amount of
nutrients in the food that so like
protein, fiber?
>> Yeah. Because if you took watermelon
Yeah.
>> Well, it's mainly water, isn't it?
>> Mhm.
>> So, you have to factor in, you can have
quite a lot of watermelon
uh to equal a chocolate bar.
>> Mhm.
>> So, the density you're all you're
looking at the density of sugar in it as
well.
>> Okay.
>> So, that's why the glycemic load is
better.
>> Was there was there a moment in your
career where
you started to question what you had
been told?
>> Yeah. you know, so you start as a young
doctor. I wanted to be part of a small
community and stay there and make a
difference. And then comes the sad bit
really. So I for the first 25 years I
was trying to do what's in the
guidelines. I was trying to be a good
doctor. But what I noticed I noticed two
things.
Number one, I noticed what I've already
said to you that the health of the
population I cared for was
deteriorating. It wasn't getting better.
So, if I'm the doctor in charge of the
practice looking after these people and
health is deteriorating,
am I not responsible? And where's where
is all this difference I was hoping to
make? It just wasn't panning out. At the
same time, I'd always in my heart felt
that prescribing lots of drugs felt a
bit wrong. It felt like a mini failure
because how is somebody well if they're
taking six tablets a day?
>> Was there one particular patient that
you met?
>> There were two two things happened both
to do with very powerful women. The
first powerful woman was a lady I'd
known for over 10 years. She and her
husband had cared for them both. They
both had poorly controlled diabetes and
they were both very heavy at the time. I
could monitor how my how compliant my
patients were with their medication.
And if I'm to be truthful, in part that
was how I was paid. So part of my
payment was to do with are the patients
having in this case metformin the most
commonly used drug for type 2 diabetes.
>> Part of your payment?
>> Yeah. Yeah. How would you?
>> Well, because there's a you're supposed
to the the government approve of the
fact that we give drugs that are needed
for type 2 diabetes. So that you're
given a sort of quot it's it's regarded
as good practice that such a a certain
percentage of your patients will be on
metformin.
>> What?
>> Yeah, it's true.
>> So is it fair to say that you were
somewhat incentivized to give people
metformin?
>> Yes, that would be true. But I think we
should also be fair to say that the body
of evidence at the time would say uh
that it's good practice to give
metformin to people with type 2
diabetes. and
conversely poor practice not to use
metformin but we'll develop that. So the
the backdrop is we're we're monitoring
the patients who stop taking their
metformin because that uh is number one
poor practice and number two actually
cost me. So I wrote to the person dear
Mrs. So and so, I'm concerned that uh
you're not you don't seem to be taking
your metformin. Please make an
appointment with me at your earliest
convenience. Very British, very polite.
Anyway, nothing prepared me for what was
going to happen that morning. And it's
changed my entire life on that point. So
the lady, well, let's call her Mrs.
Jones. That wasn't her name. She marches
in and
uh she said to me, "You think you're
going to tell me off, don't you, Dr.
Enwin?" Well, I've got news for you. I'm
going to tell you off. I was scared.
Like, what's going on? She's never been
like this before. She was a a polite
person. Anyway, she went on to explain.
She said,
"When you do my blood tests, you will
find that my blood glucose is completely
normal despite not taking your
metformin."
And she said, "I'm wondering if you're
actually qualified as a doctor because
in the last 10 years, did you ever once
tell me that bread was sugar or
breakfast cereals were sugar?" I had to
learn online
uh that bread is sugar, that rice is
sugar, that breakfast cereals are sugar,
and when I cut those foods, I don't need
your metformin now. And she went she
made it worse. She said, "This is school
boy biology. You should have learned
that when you were 16."
I was dead scared because you know
complaints as a GP, it's really bad.
They go on for years and years. But
mainly I was scared because every word
she said was true. And one thing I had
learned about when you're an older
doctor is you've got to listen to people
properly. If they're complaining,
don't deny it. Don't defend yourself.
Take it. So I said, "Okay,
I've got I want to learn what you you
know, if this is true, will you meet me
again? Let's do the blood test." So we
did the blood test. It was true. It was
the first case of drug-free type 2
diabetes I had ever seen. I'd never seen
a single case in 25 years where people
came off medication.
I was fascinated
because she'd done it like a miracle.
But there was another detail I just
shared with you. She was one of 40,000
people online learning from each other
how to do it.
And when I looked, they were being
rubbished by the health care
professionals. So people like me were
telling them, "You'll die. What you're
doing is dangerous." And I was ashamed,
really ashamed,
and it's complete coincidence.
But in the same month,
uh, we have to introduce my wife, Jen.
Is there a photo? Come on, let's see
Jen. This is Jen.
>> Oh, she's probably the cleverest woman
in the world.
>> She's so clever. I love that woman. So,
Jen, uh, so her back, she is a, um, a
clinical health psychologist and she
specializes, she's fascinated by the
role of hope in disease and the
difference it can make. And she spent
her life researching the difference that
hope makes to clinical outcomes. So, it
just so happened that she was in a
supermarket and she saw some a
discounted diet book. That one. That's
the book.
>> Escape the diet trail by Dr. John Brier.
>> Yeah, Dr. John Briffer. What a lovely
guy. So, Jen bought that book just
around the time I'm telling her about
this patient. So she said, "You have to
read this book about the low a low
carbohydrate approach to um insulin
resistance to type 2 diabetes."
And in the book,
everything that my patient had told me
was there
and but it was done in a medical way for
and I understood. She said, "David, why
why are you sort of failing? Why don't
you do one thing before you retire? Why
can't you do a cheerful something you
really believe in? Why don't you have a
go at this low carb
>> yourself?
>> Yeah. She said, "Why don't you and me
go on this diet for see if some patients
would volunteer and do it with us?"
And I mentioned it to the partners
and they said, "No,
>> these are other doctors."
>> Yeah. So I'm senior partner.
>> I'm supposedly the boss. Uh but at the
time low carb was not respectable and
they didn't like it and they said we
don't want you to do this and partly
because they said well how it you know
is that a good use of the the resources
of the practice
because if you're doing this David maybe
you're not treating chest infections or
other things and there's pressure on the
health service. this felt a bit they
felt it was a bit self-indulgent. So go
back to my wife and said the partners
say no. And she said I I I'll tell you
what we're going to do. We're both going
to work for free and we'll do it. Why
don't we do this in our own time in on
in an evening when the p is no
resources.
So that's exactly what we did. We found
18 volunteers
who were interested amongst the patients
and then Jen and I. So that was 20 of
us. We started meeting every Monday
night
talking about low carb learning how do
you cook stuff? How do you do it? We did
it together. And one of the nurses was
so excited. Heather is her name. Let's
give her a, you know, thumbs up to
Heather. Heather said, "I'll work for
free. I'll help you. I'd love to do
this. I want to I want to believe in
what I do.
And then the magic begins. The results.
I couldn't believe it. I could not, you
know, I'd never seen anything like it.
And the first thing the first thing I
saw
was the liver function improving. You
see, cuz I'm doing blood tests cuz I
know I'm doing something weird. I'm
doing something that I would be
criticized for.
So if you're going to do a weird thing,
you need to measure stuff.
>> You can't, you know, these are patients,
so you can't just experiment and not be,
am I doing harm? What's happening?
What's happening to the cholesterol and
the lipid profiles? So I was monitoring
stuff really closely.
The liver function though, Stephen, I
got people who I thought they were
drinking alcohol and I thought the liver
problem was due to alcohol
and they'd had abnormal liver function
for 10 years and suddenly within weeks
the liver function was improving often
by a third or 50%.
I was so excited. Can you imagine? And
I'm sitting there and the laboratory
results are coming in and they're like,
"Wow." And then another and another.
So that was the first thing. Then the
weight. So we're all meeting every
Monday night and we got the scales and
everybody gets weighed every Monday
night and the weight started falling off
people. It really did. And then the all
sorts of other weird stuff started
happening. some of which I couldn't make
sense of for years.
The first one was
people said, "Are you hungry?" Because
I'm not. And they started saying things
like, "Do you have to eat breakfast?"
>> Where? And I also I wasn't hungry. I
wasn't hungry. They were telling me the
truth because I was experiencing this
with them.
Why are we not hungry?
That's so odd. And I was starting I not
bothering with breakfast. So, I didn't
eat it. You don't have to have it. And
my and my belly went away. Next thing
was I noticed when I stood up from my
desk, I felt dizzy.
Weird. Now, I hadn't told anybody, but I
had moderate high blood pressure for
years, but I didn't like to be a
patient.
>> So, I never went to a doctor.
>> I just put my head in the sand. So I had
high blood pressure for years. When I
took my blood pressure, it was low
normal.
Why? I didn't know. But on the patients
as well, I'm doing that as well. I'm
measuring all the blood pressure and
it's improving. So it's getting weirder
and weirder. Liver function improving,
weight going down,
blood pressure improving.
In those days we were the blood test
that we we did was a thing called a
hemoglobin A1C. The A1C in America this
is the average suginess of your blood
for the preceding 3 months. So the
results take a while.
>> Mhm. But then when the uh hemoglobin A1C
came in there, it was we were getting
really spectacular improvements in in
average blood sugar
and that's so that's kind of how it
began. So that's 2013. So that's 13
years ago and uh
the rest is history. But that I was
completely blown away and I was full of
curiosity about all these other things
and how was it? Why were these things
improving?
>> So in those 13 years, how is your
fitness your health changed?
>> My mental powers were much greater. I
could concentrate better. I wasn't
fatty. So I noticed that. The next thing
I noticed was
I needed a lot less sleep. So yeah, in
the beginning I used to have to have a
little sleep on my doctor's couch every
lunchtime.
So I was senior partner. So you press do
not disturb and you put the curtains
round and have a little nap on my own
couch for 20 minutes. It was the only
way I could get through the day. I
didn't need that nap anymore. I was less
sleepy. I needed an hour's less sleep a
day. I could
think better. I was I could cope with
the same problems.
And this is so weird
mentally. I was stronger. It was like
being a younger man.
Um the way
>> I don't know. I think you have a sense
of mental horsepower.
>> Going back to the top of this
conversation, you talked about how
everybody listening right now has a
variety of different health futures.
>> Yeah. and which which health future they
end up in is going to be determined by
the everyday decisions they make.
>> Yes.
>> So I want to really zoom in on some of
those everyday decisions. We talked
about you and your biscuits and at the
time you said you were you were probably
quite sedentary as a doctor.
>> Yeah.
>> Sitting in a chair, patients coming in.
>> Yeah.
>> You weren't doing exercise.
>> No. Um I didn't fundamentally believe it
would make that much difference.
>> And this is such a great point. you
you've a really great point. So, let's
think about weight loss. So, I would
give advice on weight loss to my
patients and I would say eat less and
move more. And I'd even sometimes say
that Bellson thing, you know, the no fat
people came out of Bellson.
>> I've never heard that before.
>> But it's a horrible thing to say to a
patient, isn't it?
>> What's Belson?
>> Well, that that's in World War II where
they all starved things. Okay. So the
the point is you're saying to somebody
with an obesity problem,
>> it's their fault.
>> Yes, you're blaming them. That's exactly
the point. And that's what I did. And
it's worse than that because
I give them that advice and it just
about never works.
I did a horrible thing. I used to say to
them, "Right,
so why don't you just have two
tablespoons of all brand a day?"
>> Oh, breakfast cereal.
>> Yeah. uh with skim milk and I would
advise a few multivitamins
and uh a couple of pints of skimmed milk
a day. That was my advice. And then when
it didn't work, who do you think I
blamed? Them.
>> Yeah. And this was all part of my
epiphany. I never joined the dots. That
the failure was not theirs. It was mine.
And that's horrible, isn't it? Imagine
25 years of I was blaming patients for
their failure to lose weight and it was
my failure
because I didn't give them advice that
worked. And if you keep giving the same
advice to people and it doesn't work,
shouldn't I have questioned?
But isn't that happening in society
overall? How are we doing? How are we
doing with health? How's it going? It's
a disaster, isn't it? So we need to do
something different.
But for me for 25 years I did not
believe that lifestyle was key. And now
I do.
>> And that's why I didn't I didn't
think that the biscuits made that much
difference.
Obviously I knew basic nutrition. So I
made sure there's protein and there's
iron and stuff. I fundamentally
believed that drugs is what I should be
using, medication, and that lifestyle
was a sort of add-on.
Isn't that terrible? I
>> I think this is so important because it
really gets to what I believe the
average person thinks as well.
>> Yeah. Yeah.
>> Um we were talking before we started
recording about some of my friends. They
are there. There's two friends I
mentioned. One of them is a very very
successful businessman. Um, everybody
knows who this person is. And they asked
me this weekend, "Is pizza healthy?" And
I just couldn't believe I It shook my
mind.
>> Gobsmacking. It was like, "Oh, what
pizza? What?"
>> Cuz they were choose trying to choose
between they usually have a big 12-in
pizza for lunch. And And he was asking
me, "What's healthier, Steven? Uh,
Nando's chicken or this 12-in pizza he
was going to get?" And I literally
looked at him like I was looking at a
ghost. I was like, "Are you winding me
up?" And he was genuinely serious. He's
almost 60 years old now and he doesn't
know if a chicken breast is healthier
than a 12-in pizza. And the other
example that I mentioned to you before
we started recording is a very famous
Premier League football superstar legend
who you would assume had gone through
those sort of 15 20 years of being an
academy player and then a a pro alete
knows what has sugar in and what
doesn't. and he was asking me is is a
big spaghetti carbonara is that healthy
is that a health food because he said to
me during his football years they were
told always to carb load and again this
it it gave me a huge amount of empathy
because it made me realize how even
though there's podcasts like this where
we talk so much about health and even
though there's the internet now the this
information is not getting through to
the average person for some reason and
they too I believe think exactly what
you just said that health is you know
it's this sort of accessory where my
fate is determined anyway. And if I do
this health stuff, which is a bit of an
inconvenience because these Percy pigs
taste great.
>> Yeah.
>> Um or these these these candies taste
great, then I might be able to look a
little bit better, a little bit more
aesthetically pleasing, but my fate is
determined.
>> The simple point, yeah, nutrition, we're
not teaching it. So, there's only three
macronutrients. There's only protein,
fats, and carbohydrate. And yet your
friends there haven't even got the three
macronutrients and they are successful
intelligent people. So somewhere we're
going badly wrong, aren't we?
>> There is another example that's really
front of mind to me which was, you know,
I'm in Dragon's Den at the moment and
someone came in and pitched a fruit
snack business and it's basically dried
out fruit pieces. Now I looked at the
back.
>> I'm loving this already. Yeah.
>> I looked at the back. Yes.
>> And it said in the range of 60 to 70%
sugar because what they've done is
they've taken exotic fruits like mangoes
>> dried them out and now you have this
little chip which is this just piece of
mango 60 70% sugar. So I'm looking at
the back of this thing thinking this is
candy.
>> This is basically candy.
>> Thank you.
>> But I'm looking around and every because
it uses the word fruit.
>> Yes. People have this sort of halo
assumption that if the word fruit is on
it, fruit juice fruit,
>> it'll sell.
>> Yeah. And who And also it's a sort of
who cares about the consequence but will
make a pile of money.
>> Yeah.
>> Selling dried up fruit and they miss
what you read on the back.
>> Yeah. Sugar. I was like this is
>> okay. How's that? You know what? If
somebody had type two diet what for kids
is we'll just give them Yeah. And I
you've touched on another another thing
about
what's going wrong. So when we look at
my practice and this epidemic and really
as I've said already it's not an
epidemic, it's a pandemic. It's
everywhere. I go all over the world and
obesity, type two diabetes,
uh poor metabolic health is in it's
everywhere. It's everywhere.
And I think one of the things touching
on what you just said is so you you wake
up and you have your cereals for
breakfast
>> which you've got some here
>> which we have some cereals there and
then uh you'll have why don't why don't
you have a big glass of fresh orange
juice as well. Great idea. And then uh
okay, that's your breakfast. But then on
the way in, you have a little snack, and
people do. They buy a bar or some crisps
or something like that. And then even at
school, they might get a muffin midm
morning. Fair enough. They might then
have an apple. At lunchtime, you're
going to have some sandwiches.
And then you've eaten your sandwich. So
you'll, I don't know, you might have
might have a cake or something or some
ice cream. Then you'll go home and then
it's time for you, you know, maybe your
chips or your pizza. What you've
actually done is have sugar with your
sugar with your sugar sugar all day
long. There's hardly any protein going
back then to those macro. Where was the
protein to grow you, you know? And that
that's the thing that that's changed
over time that we are the snacking. So,
I've I come across a lot of young people
and their mother is saying, "I can't get
him to eat any proper food. He just eats
snacks all day long and it won't I can't
they can't get protein in them." And
some of them are actually thin kids.
They're not all fat.
>> Let's talk about what you just said
there. And we can walk through the day
using
>> Yes.
>> the food we have on this table. Now, I
just want to caution that we do have
some people that are probably out
walking their dog listening and can't
see. So, we're going to have to do a bit
of a voice over as to what's going on.
But, you said wake up in the morning,
you have your cereal.
>> Yeah.
>> Now, cereal growing up, I thought was a
health food.
>> Me, too.
>> Yeah.
>> Me, too.
>> How much sugar is in the average
standard bowl of, let's say, frosted
cereal.
>> Well, we can do this different ways,
Stephen.
>> Mhm.
>> This is actually like a test for you
laid out here.
>> Oh, gosh. Is that okay?
>> Yeah. This is a test for you, and I'll
describe it. So, what you've got, you've
got um
a bowl of we'll call them they're corn
flakes.
>> Then you've got a potato, a baked
potato. It isn't baked yet, but you
could bake it if you want. You've got
150 grams, and this is boiled rice, so
it's not dry. It's boiled rice. You've
got a very ripe banana.
And at the end there, you've got a
delicious looking chocolate bar.
>> Yeah. So you've got there uh some cubes
of sugar and this is the test bit you
see
>> as to how I'm going to give you we'll
score you in the end. Okay.
>> So what I'd like you to do is consider
these relatively
>> and each of those cubes of sugar
represents a 4 g teaspoon of sugar.
>> Yeah. So, if you could now just go along
these and put beside each food what you
believe to be the equivalent in terms of
teaspoons of sugar and then I'll give
you a score and see how you do.
>> Okay?
>> And and those are the answers. So, I'm
going to turn it down so you don't
cheat.
>> Okay? So, I'm going to score them as I
would have thought two years ago.
>> Thank you.
>> Because because two years I've
interviewed a lot of experts, so I'm I'm
generally quite shocked by all these
things, but I'm going to score them as I
would have thought when I was 31 years
old 2 years ago. So, That's great.
>> Cereal, honestly.
>> Yeah.
>> Um I
>> And there's no sugar on it. It's not a
sugared cereal. It's just the dry
flakes.
>> I honestly didn't think there was sugar
in that.
>> Yeah.
>> So, if you had pushed me, I would have
>> We'll give it one, eh?
>> I'll give it one. But I didn't think
there was sugar in that.
>> One
>> again. A potato. I didn't think there
was any sugar in a potato. So, even
giving it one feels like I'm lying
because I didn't think there was sugar
in a potato. And I'll be honest, rice, I
didn't think there was any sugar in
rice.
>> Okay.
>> A banana,
>> it tastes sweet.
>> Yes.
>> So, my brain would have said one.
>> Yeah.
>> But this uh this chocolate bar that's in
front of me, I would have said I'm going
to say two.
>> Okay.
>> Two or
I'm going to say three,
>> right?
>> I'm going to say three. I actually think
it was two, but
>> that's how much sugar I would have
thought was in all of these things here.
Cereal, a potato, white rice, a banana,
and a chocolate bar.
>> Right. Well, to be fair, I still kind of
do, but I know better.
>> So, now I'm going to give you the
correct figure. Now, uh this is worked
out from the glycemic load that we
already discussed. So, I explained about
the glycemic load
>> and then so in clinical practice, I had
a problem and my problem was in 10
minutes trying to explain to you how you
could eat differently and why you should
eat differently. And so I needed a way
of quickly communicating with children,
with old people, with a teacher the
consequences of dietary choices.
>> So I came up with a new idea which was
why don't we represent the glycemic load
and instead of using
grams of glucose which nobody
understands and what's glucose anyway.
Instead of doing that, we redid the
calculations,
redoing it for t four gram teaspoons of
sugar. And that's my teaspoon of sugar
equivalent system. And I'm using that
now to give you the correct answer.
>> Okay.
>> Right. So the the cornflakes is one,
two,
four,
five, six, seven, and eight.
One, two, three, four, five, six, seven,
eight.
>> With no frosting.
>> No frosting.
>> No milk, nothing.
>> The potato, obviously, it depends on its
size. That's quite a big one. So, that
one is one, two, three, four, and
there's more. Five, six
is nine.
There they go. equivalent of nine sugar
cubes.
>> Is that nine?
>> Yeah.
>> Right.
I'm going to leave the rice till last.
That chocolate bar is actually You can
do it for me.
>> Is seven and a half. So you
>> you can give it seven. Seven.
Seven.
Now, the banana depends on the size and
how ripe it is. A ripe banana has more
sugar in as you probably know when you
eat it. But that, let's say that banana
is quite a ripe one. It looks quite
ripe. Let's say that's six cuz it's a
big banana.
>> Oh my gosh.
>> Okay, then the final one obviously is
going to be the killer, isn't it?
>> I thought rice was healthy.
Well, I thought it depends.
>> Was really healthy.
>> Depends. So, one, this is 150 gram of
boiled rice. 3 4
5 6
7
8 9 and
10. So, that's the winner. And I would
say that's the single fact around the
world. So, my my teaspoon of sugar.
There we are. That's one of my teaspoon
of sugar charts. So, what you've got
there is the food,
the glycemic index,
the the serving size, and then the
teaspoons of sugar there. So, this is
available. The public health
collaboration is a charity I helped set
up with Dr. Rangan Chattery 10 years
ago. It's our 10th anniversary tomorrow.
These infographics,
there are actually far more than this.
This is there's seven more. They're
available in 35 languages. Volunteers
have translated this to go all over the
world. It's not copyrighted. I want
people steal it, take it, use it. So the
the white rice fact
I would say has astonished people all
over the world and led to me becoming
far better known.
>> What what about orange juice? A lot of
um parents including my parents give me
gave me orange juice and I used to think
that orange juice was a health food. So
I would literally I'd go to the fridge
I'd get open the sunny delight or
whatever it was
>> sunny delight
>> and I would drink that and I'd think I'm
going to be strong and big and my body's
going to love me. Well, let's so that
there's a lot of sugar in orange juice.
There's a lot of sugar in orange juice
and you've taken away all the once you
take it from the fruit as it was meant
to be and you juice it, the sugar hit is
fast. M
>> so what that does is if you think if we
go back to insulin again
um so you you you drink the orange juice
your blood sugar goes up rapidly so your
body responds rapidly with insulin then
you what happens your blood sugar falls
but then you're kind of hungry again and
that's what happened to me with the
biscuits wasn't it I ate biscuits
my blood sugar is up. Then insulin comes
in heavy and slow but too much. Then I
thought I was having a panic attack cuz
I had low blood sugar. And what's the
answer to that? More biscuits. And round
you go. Round. And that's how without
thinking you'd start the day. Starting
the day with a sugary breakfast
without enough protein in it is driving
hunger. And then you wonder why you're
ravenously hungry at 10:00. There was a
few others that shocked me. One of them
was um I was in Peru and obviously Peru
is quite famous for chocolate because of
the cacao and all that stuff. And so we
went to a chocolate making class
>> and um he told us to make dark
chocolate, normal chocolate and then
white chocolate.
>> Yeah.
>> And when I made the white chocolate,
this guy got me this big glass cylinder
and he goes, "Here's some white sugar."
He goes, "Pour it in." So I, you know, I
get it and I pour some in and I and he
goes, "No, no, no, no, my friend. Pour
it in." Yeah.
>> And I pour it and pour it and pour it
and pour it and pour it and pour it. And
I'm not
check.
I feel like I poured into this huge
glass cylinder.
>> Yeah.
>> 80% of white sugar.
>> Yes.
>> And then
>> it's true.
>> Yeah. And then and then he said, "Put
some syrup in." I was What?
>> This is This is white sugar. It was like
some syrupy stuff, some oil stuff. And I
was like, "So, white sugar?" Um, so
white chocolate is like 80% white sugar.
>> Yeah.
>> I've never eaten white chocolate since
ever.
>> You That's so important. So very often
people think they're a choahholic.
>> That's really common that people say to
me, "I'm I'm addicted to chocolate."
>> If you look at if you actually look at
how much sugar there is in milk
chocolate,
>> uh, you know, there's many teaspoons of
sugar in milk chocolate.
If you eat 90% dark chocolate, there's
only about two teaspoons of sugar in a
bar. And what you find with the
choahholics is I say, "Well, if you're
addicted to chocolate, why don't you get
a bigger hit and have the dark
chocolate?" And they say, "Oh, I
couldn't eat that. It's too bitter."
What they're actually addicted to is the
sugar. what there are. So I've done a
there is for the the folks at home there
is one of these sugar infographics on
chocolate on that subject of chocolate
because I want people to understand the
consequences of what they do.
>> So just to illustrate this because I've
just we've just looked up the stats,
right?
>> I think this is this is this is what I
saw, right? I've just looked up the
facts to make sure I'm saying is true.
When I made that bar of white chocolate
in Peru,
>> yeah,
>> this was the total ingredients and this
is how much sugar I they asked me to put
into it.
>> Blind.
>> I've looked at it and thought, okay, so
white chocolate is basically like 70
odd% just pure white sugar and nobody
knows.
>> Yes, exactly.
>> Nobody knows.
>> Exactly.
>> The other one I've got to be in my
bonnet about is smoothies.
>> Yes, I want one, too.
>> I thought smoothies were healthy.
>> Yeah. No, they're the, you know, I'm on
X or Twitter quite a lot and that's the
kind of thing fills me with rage and I
have to take a photo with like my Look
at the sugar. Uh, there was Yeah, it
fills me with rage. I've got another
thing. This is fun. I've got another
I've got a question.
>> Right, Stephen?
Why don't we We could take all the blood
out of me,
>> right? There'd be five liters. We could
bleed me out right now. There would be
five lers of blood in me. Let's get it
in a bucket. All right. Five lers of
blood. How much sugar would be in that
five lers of blood?
>> I have no idea. I didn't.
>> But it's an interesting question, isn't
it? Because it relates to the
consequences of eating some of these
things. So, I would just like you to
estimate. So, if let's say my blood
sugar is normal.
>> Yeah. Um, if you have a normal blood
sugar, I would like you to guess how
much sugar is there in my entire blood
system.
>> One one cup like this.
>> Thank you.
No, the answer is this. Let me show you.
That is all there is.
>> You're joking.
>> I am not. And you see immediately
>> one sugar cube.
>> That's all. And I'll do it on Twitter
for you. X I can show you the
calculations.
So you see, if I have a banana
and I have diabetes, the there's too
much sugar for me. You see, because
glucose is number one vital, but number
two toxic if you have too much of it.
The level of it in my blood is
controlled minutely.
>> Wow.
>> It's controlled to this extent. And I
think that single fat, you didn't know
that, did you? I did not know how to.
>> And it it immediately shows you how it's
so easy to have more sugar than you
actually need.
given that
>> and if your insulin stops working.
>> So for me, I've done an awful lot of
this. So I monitor my blood sugar with a
continuous glucose monitor and I get my
blood sugar up on my phone so I can
check at any time what my blood sugar
is. And we'll do it in a minute and see.
But you see, if I if I eat a banana, it
doubles my blood sugar because I can't
regulate my blood sugar
>> because of the diabetes.
>> Yeah. So, a whole banana
is far too much for me and will double
my blood sugar because you see if I'm
only supposed to have this much and I
have that much.
>> Gosh. Yeah.
>> It's too much for me and I feel ill.
>> Giving, you know, I go out into the
world and I speak to the people that
listen to the show and they're like taxi
cab drivers. It's a lot of taxi. Do you
know I wonder I've got this bias towards
thinking everybody that listens is a
taxi. I've got this bias towards
thinking that everybody that listens is
a taxi cab driver because I really only
spend my time in the office or in a
taxi. So, I get lots of feedback from
these cab drivers and the average person
out there listening now,
>> they don't know how to check if the food
they are eating is good or not because
the labels on these foods I I've got so
obsessed by the marketing.
>> Yes. And um you know I was looking at
this bag of sweets the other day and it
said made with real fruit juice and they
put it front and center and I I was
almost tricked. So I can't imagine
someone who like me who doesn't spend I
can't imagine someone who doesn't spend
their time interviewing health experts
how easily the general public is being
tricked. So what is your advice in terms
of spotting this stuff? Like what do I
look at? Cuz right now I spend a lot of
time looking at the sugar part.
>> Yeah that's great. There's different
ways we can do this and obviously this
is how I spend every clinic. That's I'm
in clinic yesterday. This is what I'm
doing. I'm trying to help people
understand.
It's sometimes easier to talk about what
maybe what you would eat rather than
what you wouldn't eat. So I for somebody
with insulin resistance or type 2
diabetes, I would tend to say, well, why
don't you base your meal on protein? So
what have you got in the fridge? Could
it be chicken? Could it be eggs? What
would it be? So that's your protein.
Have loads of it. Then I'm thinking,
right, green veg.
Will you What green veges would you
tolerate? What green veg could you buy?
Might be frozen beans or it might be
salad or whatever. And then I'm saying,
how would you make that green veg
tasty?
>> Pour barbecue sauce on the top.
>> Ah, no. Full fat mayo. full fat mayo or
butter or olive oil or whatever. So that
>> I say barbecue sauce because when I
looked at the back of mine, I had the
shock horror of realizing that there's
>> it's a common one.
>> 30 sugar cubes in a bottle, a standard
bottle of barbecue sauce.
>> It's just pouring sugar on top.
>> It is. It is. You have to be so
vigilant. And I I think to do it
successfully,
I'm quite interested in the idea of
could you eat real food that's not in a
packet.
It's it's it's Russian roulette food out
of packets. And yet I understand my
patients north of Liverpool, you know,
where are they going to buy the stuff?
So I try and help them with
you could do it that way. If you're not
if you're going to eat stuff out of
packets, you have to wise up and you
have to look at the carbohydrate
content. And bear in mind, every four
grams
is broadly equivalent to sugar. So if if
if there's a if there's if something's
got 100 grams of carbs in it, I've
already said carbohydrate varies in how
sugary it is, but it gives you an idea.
It's very sugary. So you see the the
error you made with the corn flakes is
there's no sugar there but it's all
carbohydrate
>> and it it's a very sugary carbohydrate.
I think we need to just explain that for
people which is when I looked at those
corn flakes the question I asked you is
they're not frosted so there's no sugar
on them but what the body is doing is
it's converting the carbs into glucose
>> right I've got a good way so we have to
think of starchy carbs as actually
glucose molecules holding hands
>> okay
>> and then digestion comes along and
breaks down
they're they're not holding hands
anymore more and they become free sugar
again
>> cuz we think if it's not sweet it's not
glucose.
>> Exactly. Exactly. I don't know whether
when you went to school was it this
thing where you chewed bread for ages
and then you could see if it became
sweet or it turned into sugar. It's a
school boy experiment that's done a lot
to prove that uh the amalayise the
enzyme in spit uh turns starch into
sugar. But that's the point starch is
soon to be sugar. glucose holding hands.
Yeah. And when it holds hands, it's not
sweet. But then when you digest it
Exactly. it's no longer holding hands.
>> Perfect. And that was is broadly what?
>> And you're not alone because didn't I
make that error? Isn't that what the
lady in 2012?
That's what she was so furious that I
was making. So here here we are, senior
partner of a large practice
had forgotten
uh that starch was sugar. And we come
full circle because and so many other
people they they patients say to me,
"Dr. Roman, I know uh not to have sugary
things. I've given up sugar in my tea
and coffee and I don't understand why my
blood sugar is so high." People say that
very often. And then of course we use
the teaspoon of sugar equivalents or a
continuous glucose monitor to really
show them what's going on.
Something that a lot of people have is
bread.
>> Yes.
>> Um, white bread. So, I I did some
research and it said a single slice of
white bread contains about 0.5 sugar
cubes, but a full loaf can pack up to 12
cubes of sugar in it.
>> That's true, but it doesn't it doesn't
include the fact that the wheat that
makes the bread will turn into sugar as
well.
>> Okay. So on my teaspoon of sugar
equivalent,
even a small slice of brown bread is
about 3 teaspoon of sugar.
>> Is there a healthy bread?
>> That's a really great great question.
And of course it depends how well your
insulin's working. So if you're young
and you take a lot of exercise and your
insulin's really good,
then maybe brown bread is is okay. If
you're like me though with insulin
resistance there it would have to be low
carb bread. So I wouldn't normally eat
bread under any circumstances but I
might have low carb bread.
>> I did some research said sprouted grain
bread. Never heard of that before. Or
100% whole grain rye are the healthiest
options because they contain zero added
sugar and high fiber.
So,
>> right. I mean, what I'd say to people
>> again, it depends. How much exercise do
you take? How do you know? Have you had
your fasting insulin measured? Do you
know if you're insulin resistant or not?
>> Mhm.
>> Um,
if you're healthy, take lots of
exercise. Sounds good. Fair enough. If
you if you're beginning to develop a
tummy, well, maybe not so good. And if
you don't know,
I'm a great one for experimenting. And
that's where I come back again to
consider
uh buying a continuous glucose monitor.
The thing you wear on I've got one on me
now. And it tells my phone how is my
blood sugar. So I can experiment then. I
could try your bread and within an hour
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>> Am I wise to be looking at the back of
packets? I look at the back of
everything I eat.
>> Yes.
>> Um and I'm building, I guess, a mental
model of the different levels of
carbohydrates and sugar content and
fiber and all these other things and
proteins, etc. But I always seem to zoom
in on the sugar,
>> the added sugar.
>> Ah, right. There is an error there.
>> Okay. So you that's brilliant and you
the fact you're interested and trying is
great because you'll learn so much more
because of course
the sugar is one thing but you must also
look at the carbohydrate
>> the carbohydrate content. Now um this is
done differently in the United States
from here.
Confusingly here we talk about
carbohydrate
separately from fiber. So that in the UK
when it says carbohydrate that turns
into sugar. In the states you've got uh
the carbohydrate including fiber. So it
makes it more complicated for you
because you need to know which how much
of that carbohydrate are you going to
absorb. Well, let's go back to the three
macronutrients. So
you should be interested in
protein. How much you want? You want you
want to be a musly kind of guy. So you
want your protein. Uh the carbohydrate.
Well, why do you need that? I'm
wondering. And then fats. Well, you
might need those for fats soluble
vitamins. So those are the uh the three
things so that you become more
sophisticated and if things have a lot
of preservatives, if they have an awful
lot of ingredients, I'm immediately
suspicious.
>> I think one of the things that people
that I've come to learn through
interviewing people like yourself is
that it's not just the direct
consequence of having a big uh glucose
spike or
you know having high blood sugar. It's
also the fact that when I eat things
like Mars bars or the white rice here, I
then get more hungry later.
>> Exactly.
>> Which means I eat even more sugar that
same day and the next day and the next
day.
>> And of course, that's what my patients
right back in 2013, it was the absence
of hunger they found fascinating. And I
did cuz I'd been hungry all my life
because all my life I'd been uh carb
heavy. And I didn't realize that the
more carbs you eat, the hungrier you
become. I don't know. Have you ever
tried fasting? I bet you have.
>> Oh my gosh. Yeah.
>> Right.
>> I fast most days to be honest. I haven't
eaten today. And what time are we? Well,
I don't know. Uh 1 1:00 p.m. And during
the Dragon's Den filming, I I don't eat
often until the evening. So
>> great. So isn't that interesting? So I
used to I used to have a model which was
um that if I didn't eat, I was hungry,
right?
>> Mhm. So if I didn't eat for even twice
as long, I'd be twice as hungry and it
would rise exponentially until I went
mad.
>> And what's surprising that you must have
found is as you fast, you don't become
more hungry, do you?
>> Yeah, it's crazy.
>> Well, isn't that interesting
>> that actually get the more I eat, the
hungrier I become.
>> When I'm on keto,
>> pardon?
>> When I'm on keto,
>> yeah,
>> I I can't believe I can't It's like
hunger just vanishes. The other thing
that the remarkable thing I love, what
are those cinnamon roll things? I love
those cinnamon rolls usually. I love
them. And when I started doing the
ketogenic diet, which is very, very,
very low carb. I remember walking up to
this cinnamon roll concession stand in
Cape Town and looking at them
>> and they were doing nothing to my brain.
There was no temptation.
I've had that.
>> It's like a superpower.
>> Honestly, I've had that with Christmas
cake.
>> It was my kryptonite. It was the kind of
thing I was sneaking down when they'd
all gone to bed and having more.
>> And then one day you can look at it and
it and you think it's not actually food.
>> Your brain that isn't food.
>> Yeah. Exactly.
>> And I'm the same with buns as well and
all sorts of things that a lifetime of
and they're no longer food and it feels
like a superpower because I can I'm such
a man. In fact, I I throw this down as a
challenge to men. Are you man enough
>> to resist? You know what? Whatever it
is.
>> Let's do a challenge. Come back in a
week and tell me you've not had any
biscuits.
>> It it it it works. It works.
>> What do you think of the ketogenic diet?
>> Wow. That's a Oh, that's a big question,
isn't it?
And don't you think we need to begin
with what you want? So, I think we need
to begin with your goals and hope. Why
would is it are you wanting to lose
weight? Are you wanting to sort out type
two do diabetes? Or I'm I mean George
Reed, Dr. George Reed is a close friend
>> and nutritional psychiatry is really
growing and the Ian Campbell in
Edinburgh University is doing some
amazing work with bipolar disorder and
other things. So why are you doing it?
That's so that's my first thing because
there's I see it as there is a spectrum
of carbohydrate that you're on. So I try
and find out where are you now and I you
know approximately where are you now and
then I'd say well could you could you
give up bread or reduce it and then I'd
say let's let's measure whatever
parameter we want which might be blood
work or weight or whatever then we say
how are you doing are you happy now is
this is it or do you want would you like
to go a bit lower and what I've
discovered with my patients over 13
years is they tend to go lower over time
because when they experiment
>> when they go keto, what they like is the
brain thing.
>> Oh gosh. Yeah.
>> And that's what I'm that's right. So I
would say to you now cuz I'm interested.
Yeah.
>> Why would you go keto? What are you
after?
>> Um so I'm going to put the brain thing
at the top of the list which is just the
clarity of thought. Obviously in my job
I have to sit here with very smart
people like you and I have to talk
sometimes for three four hours whatever
it might be. But also, I'm on television
a lot now and I'm speaking, you know,
cameras, nine cameras rolling BBC 1 and
I've got to think of something smart to
say to this entrepreneur sit in front of
me on that's pitching to me. And then
also I'm in meetings, you know, I'll
leave this conversation now and I'll go
straight downstairs and I'll have two
hours of straight meetings about very
very complicated things about buying
companies. I'll be meeting founders,
interviewing people. And what I've
noticed profoundly because so much of my
job centers on speaking and articulation
is there is this wild wild variance that
I hate.
And what I mean by that is some days I'm
on it
>> and some days I am almost embarrassed by
my inability to string a sentence
together. Today I'm I'm almost testing
myself now by trying to speak really
really fast and see if my brain's
connected to my mouth. That's like
that's actually like what I do. I try
and see if I if it flows out. Today I'm
okay.
>> Yeah.
>> Um but there are days where I'm
stumbling over myself
>> and I go what's what's causing this?
What's the causal factor and how do I
prevent this? That's one. Keto, when I'm
in keto, I always sound like Buster
Rhymes. it always just
>> it it's always uh it's always working.
>> And then I'd say the aesthetic stuff
because I want to look good as well,
especially for, you know, my fiance. So,
I want to be in shape. I want to be uh
And then I'd say the third is being
strong. And then the fourth is I want to
live long.
>> Exactly.
>> I want to have a long health span, not
just a long lifespan, but I want to be
able to do things as I age.
>> So, you see, you're that's exactly what
I began this meeting with. you've got a
clear idea about your preferred future.
>> Mhm.
>> And it's it's it's it's fairly specific,
too. And the more specific you are, the
more likely you are to be successful.
And then you're noticing. Then
afterwards comes the feedback.
>> Do you think most people even have
thought about this?
>> No.
>> I was just thinking about my listeners
and I was thinking they're listening
right now. I wonder if they have written
down their top four.
>> Yeah. So I do you know what I'd love to
do now is tell you something about my
wife's work because it relates to
changing behavior fast and that she
won't mind. So that we're back to Jen
now. We have a woman. She spent two
years
um thinking about CBT and what was what
this is a type of therapy and what were
the necessary parts of it and what was
junk. and she reduced CBT down to
something I'll teach you right now. All
right. So, we'll off we go. Off we go.
>> So, the first thing is to think about
your health goals. So, to think about
what in a year's time, if what you do is
great, how does that look specifically?
So, I'll give you an example. You might
think you'd like to lose weight, but
that isn't specific enough. I want to
know what difference would that make to
you? So, we'll do it now. So, you said
you wanted to be in shape.
>> Yeah.
>> What I don't know what do you mean by
that. Do you want to lose weight? What
do you tell me more?
Um, I want to be
able to
h
what I'm really I think scared of, I'm
going to be completely honest,
>> is I'm scared of
>> having the same health profile as my
dad.
>> Ah, right. Yes.
>> Because I've seen we have the same, you
know, we have a lot of the same genetic
profile.
>> Yes.
>> So, I think a lot of us look at our
parents and go, "Is that my future?"
>> Yes.
>> Yeah.
>> And to make it even more specific, I
remember walking down some stairs. I've
said this once before, but I remember
walking down some stairs in Bali,
>> long steep set of stairs down to go
white water rafting with my fianceé. And
I remember those stairs recrafting
because we've got to walk back up these
stairs.
>> And so my dad would have lost out on one
of the great joys of life, which is
doing enjoyable things with friends and
people you love because his health is
now in that regard is gone.
>> Um, so I've always thought of that. And
then generally like I I remember when I
was younger, my dad used to play like
football with us and and all these
things and he's unable to do that now.
Um and so I'm and because I've done this
podcast so many times with health
experts, I realized that the decisions I
make at 30, which is where I am now,
exist on this really interesting, quite
predictable curve of inevitable decline.
However, not like inevitable
uh loss of lifestyle. What I mean by
that is I just have this picture in my
head of all these graphs I've seen where
like your peak is around maybe 2030 and
then you're going down which we all
accept
>> but how far you go down is determined by
decisions you make right now.
>> Absolutely.
>> The decisions I make now will end me at
70 80 years old in either the inability
to walk or the ability to run.
>> Yeah.
>> And it's all about what I do now. is so
that let's just refine that. So we've
we've we've I've got your goal. Yeah.
Now
>> so let's let's park your goal.
Now the next thing we've got is in the
past what have you done that's worked
towards those goals. So you probably
tell me some stuff you've done that's
worked.
>> Um
things like going to the gym.
>> Yeah. Yeah. anything anything quickly
that you did that worked that that was
is is a is a first you know helped that
you did and you remember that worked so
tell me anything
>> so I said to myself one year that I was
going to go to the gym every single day
terrible idea because I got 5 months in
and then I missed a day then it was over
I said to myself another year I think
this was 2017 that I'm going to get a
six-pack for summer terrible idea
because when summer came or I got the
six pack
>> my question was what did work in the
past not what didn't work so what has
worked for you in the past
>> so those two incidents um helped me
change my idea and the idea that I came
up with was I set not a achievable thing
as a goal but consistency is the goal
>> and consistency became for the last four
years this idea that the goal my fitness
goal is consistency means that every day
I wake up I get a shot at it and if I
up today then I've got another shot
tomorrow
>> right leave it there that's good so we
we did the goal and then we did the next
thing what what I just the next thing is
is resources is
>> Mhm.
>> So it's it's what do you bring to the
consultation that you've done in the
past? Intelligence, resources, friends
that will help.
>> Yeah.
>> You come already with expertise in
yourself. So it's not I'm not the expert
to tell you what to do. You've already
got some stuff. Yeah.
>> Then we go to the next thing. So if we
had your goal at the beginning which was
the fitness and the so and so today what
might be a small step towards your goal
a realistic small step towards the goals
we've already established.
>> So I can think of two good
>> one of them is uh creating a social pact
which again was one of the things that
helped. So we made a WhatsApp group.
This is quite funny. We made a WhatsApp
group. We put 10 friends in it and we
made a simple rule. Whoever's the least
consistent every month is evicted and we
invite a new friend in.
>> Wow.
>> We've done that for four years. I've not
been evicted in four years, which means
that I'm doing enough. I'm consistent
enough over those four years
>> to not be evicted. Every day when we
work out, it puts our workouts into the
group chat
>> and um every every week and every month
um there's a winner and there's this
league table
>> and you get these little emoji medals
and there's actually I won one year so
I've got this physical massive gold belt
on my bookshelf at home. It says fitness
blockchain world champion.
>> Brilliant.
>> So I've done that for four years. Um so
a social pack really helped me the the
sort of accountability to others. Yeah.
>> And the other the other honestly was
just
as I said a second ago when I set the
the goal of going to the gym every
single day, I set myself up for failure.
Now I set myself the goal of
consistency, which means that I can do
have bad days where I do 20 minutes or
15 minutes. Yesterday cuz I was finished
Dragon's Den late, drove down to London,
got home at 1:00 a.m. I did 18 minutes.
>> Yeah. and reducing the size of success
really helped me to
keep my feeling of momentum.
>> Brilliant. We're nearly at the end of
your degree in psychology. Okay.
>> And I'm going to pull it together.
>> The final thing is
um when things if you what would you
notice
for you when things are going well? What
would you notice?
>> So you've done some of these things.
What is it you actually notice
>> as in the benefit to me?
>> Yeah. What what do you notice? So if you
do if tomorrow is a really good day,
what might you notice at the end of it?
Cuz you've much experience in this now.
What would you notice?
>> I mean the first thing that comes to
mind is just how I feel.
>> Yes.
>> I just feel
>> Do you mean emotionally or
energetically? Great.
>> All of it. Emotionally I feel good about
myself.
>> Yeah.
>> Um energetically I feel more energetic.
Um, and there is this um
there is this element of identity in
there where I have an opinion of myself
and who I think I am and I think I'm a
healthy person and I think I'm someone
that's in control.
>> And when I'm when I'm not going when I'm
not performing the consistent behaviors
that I want to I think I start to
question that identity in a way that's
that causes a lot of discomfort and say,
"Well, you're not in control of your own
life." Like, how that's that's crazy.
>> So, I think it it links into
self-esteem. Yeah,
>> it really. So, what we've just did, we
had the goals G.
>> Yeah.
>> Then we had your resources R.
>> Yeah.
>> Then we had increments. What things had
you done? Little things on the way. And
then finally, I invited you to notice
and reflect. And that spells grin. And
that's Jen's published grin model. I
just did it for you right there. And I
could do it faster than that. I do it in
nearly every surgery I do because what
I'm trying to do is find out about you.
>> Mhm.
>> And you didn't find out much about me in
that process, did you?
>> No.
>> But I found out a lot of really useful
stuff to you and it's motivational. And
much better to do that than me tell you
what to do. And I'm not a talking
leaflet, but motivation, this is what
Jen has taught me, is key in everything
we do. And the grin model isn't bad.
clever woman.
>> So what do we do with the grin model?
And so this is really helping me figure
out how to change my behavior. Like how
how does one apply it or are you saying
that everyone listening now should
should answer those four questions
themselves? I do because otherwise it's
possible to spend a lot of time blaming
yourself,
>> you know, and particularly around if
we're discussing weight problems and so
on, you can spend a lot of time saying
I'm to blame or I wish or I shouldn't
have that. You know, after Christmas,
everybody feels like this. But what is
much better rather than focusing
you're wasting energy if you start
thinking about guilt and negative stuff
and what Jen's trying to do is getting
you to engage
by in in thinking about a better future.
And what the whole of that five minutes
was engaging you in in
first of all the goal of a better
future, then some resources towards your
better future, then the first steps
towards the better future, and then
noticing what's good.
>> Mhm.
>> Because I think in medicine, what we've
done, how do you get a doctor's
attention? You get a doctor's attention
by saying, "Oh, it's so bad. It's so so
bad. My pain is so so bad. And I
realized I had trained my patients to
think that moaning was how you know they
got my attention. And if you do that,
the result is a very miserable 2-hour
surgery.
But if you can talk, even people having
a a terrible time have got hope if you
can find it. They have goals if you can
discuss them. And you could have
somebody with a drug addiction or what
you know I see people dying people all
sort every clinic I'm seeing sad stuff
but if you can also investigate
hopes and good stuff as a doctor I'm so
much more energetic so much more hopeful
I'm having a great time and I wasn't
when I was 55 and that's the process
>> I bet there's so many people listening
now that maybe they you know because
they listen to this show and they've got
the sort of basics. They go, "You know
what? I understand this stuff and I'm
making good progress, but I live with or
love someone."
>> Yes.
>> Who I I'm I'm scared they're going down
a slippery slope and I don't know what
to do. Do I intervene? Do I hide their
sweets? Do I blame? What do I do?
>> That's so hard, isn't it? That's so
hard. I think you can.
>> Weren't you in that position to some
degree?
>> Yes. Uh yeah. So, uh, my first wife had
a very severe addiction problem. So, I
lived with that for 12 years and she's
unfortunately died now. Um, so I lived
with very, very serious addiction for 12
years. And what you're doing then is
you're living with uncertainty.
Serious uncertainty.
Uh, you never you cannot say what you'll
come home to. You have no idea. No idea.
It brings chaos into your life. It's
very very hard.
>> Addiction.
>> Yes.
>> Are you able to say what kind of addict?
Was it a food addiction or a drug
addiction or
>> It was a It would nearly everybody
concerned has died now. So I don't know
whether I can say or not, but it was
very serious multiple addictions. I will
say that. And she had she died some
years ago.
And it doesn't it it it actually wasn't
food addiction. Mhm. But it brings I
have so much sympathy with dealing how
how hard it is to deal with uncertainty
and not be able to you love somebody and
you can't do anything. It's very hard.
There are things you can do. I think
um if you can engage people in in that
talking about goals that can help.
Uh what we will do now is we'll change
that conversation to to the current Mrs.
Unwin, which is what we laughingly say.
This is Jen. So we we've been together
for 30 years now.
And Jen's story is that she actually is
an ultrarocessed food addict genuinely.
And what that means is I didn't un
neither of us understood what that was.
Even though she's a consultant
psychologist, she didn't realize that
she was an ultrarocessed food addict.
What she saw it as was a weight problem.
And all her life she's she's been
boomerang dieting. So she'd be a big
woman and then a little woman and a big
woman. And I used to watch it all.
What's going on? And then she would
there'd be tray bakes like she's trying
to lose weight and making tray bakes
saying it's for the children and then
scoffing the lot herself.
So then I'd because I loved her and I
think blo we try and solve problems
don't we?
>> We're like caveman you wanted to rescue
her. So, I'm I'm either throwing the
food away
or I'm tackling her and then she we're
having such arguments cuz she's
defensive and cross.
I I couldn't understand with an
intelligent woman what's going on. But
then uh this is only a few years ago.
She understood for the first time this
is addiction. When you have intelligent
people,
highly, highly intelligent people doing
stuff that harms their health
repeatedly,
is this not like cigarettes? Is it not
like alcohol? That is ultrarocessed food
addiction. And there's a patient I'd
like to tell you about that is explains
it even more clearly. And this patient
has consented for me to tell you because
he wants to help the world.
So, this is a guy who's a very
successful guy. He runs um he's a
wealthy person with a successful
business. He's not stupid.
He has type 2 diabetes. He's 55. He has
type 2 diabetes. He's very much
overweight.
Unfortunately, he needs really serious
surgery because both his knees have been
so destroyed by his weight that he can
hardly walk because he's in real agony.
But his type 2 diabetes is so bad, his
blood sugar control is so bad, the
anesthesis won't touch him. So he's
trapped, he can't get the OP because his
blood sugar is high. He can't run his
business easily because he can't hardly
walk. So obviously what we do is we say
you need to go low carb.
And it works for a bit and he loses some
weight, but then he gains the weight
again. And this goes on for four years
while I see him so regularly every
month. What's going on? What's going on?
Oh, excuses. The grandchildren.
Um, I've got a holiday, Christmas, it
goes on. Anyway, then his wife came to
see me and she said, "Dr. I need to
level with you. You need to understand
what's going on. I find that my husband
is getting up at 4 in the morning and
eating bread out of the fridge.
So what I do now, what I started doing
was at the end of every day, I put all
the bread in the bin if it hasn't been
eaten that day. But then I discovered my
husband was going in the bin to eat the
bread.
Then what she does, she's a a a very
formidable woman. She started putting
detergent, liquid detergent on any bread
that goes in the bin. But he still eats
it. He's getting up at 4 in the morning,
rumaging through the bin to eat the
bread with the detergent on. So then she
tries something else and she says, "This
is the only thing that will stop my
husband from eating bread if it's there.
I spray bleach on the bread and leave
the can of bleach by the bin so he knows
don't even look."
Okay. What I've described to you is
addiction. This is an intelligent
person. and imagine his self-esteem, how
it was to live like that, concealing
what he was doing
and not telling his doctor cuz I'm
trying so hard for him for years and
he's so sweet to me now and he often
shakes my hand and gives me a hug. He
said, "You tried. You really tried."
Anyway, my stories have a happy ending
always. What I did for him in the end,
he needed everything. So, low carb. Then
I got him using a continuous glucose
monitor.
>> Mhm.
>> So that he would get feedback
immediately and see that spike and also
I could see the spikes as well cuz he
had to come and show me his tracings.
>> And on top of that, I did something
unusual. I gave him a low dose of the
new GLP-1 drugs,
>> one of those. Yeah. Um and the three
together
he managed to not he couldn't moderate
but he could abstain and then he could
do it. The ampic helped reduce the noise
the cravings in his head. The feedback
from the CGM helped him know how he was
doing and the support he got from me and
the low carb pulled together and all
three and he's had his operation now.
And so it's a happy story, but he's got
maintenance all his life. He's going to
have to sort that out. Um, and it's a
wonderful example because I think we
trivialize this. We call it carb creep
like it doesn't matter. But there are
many people listening to us right now
and they know they know they're addicted
to various foods. They know because when
you ask them, they often burst into
tears. Often I somebody will say I've
never told anybody in my entire life
about and bread is a common one and if
you're not addicted to bread you can't
imagine it but if you are addicted to
bread they say this sounds so stupid I'm
so embarrassed to tell you I can't
control how I eat bread
>> and so it's not great for your
self-esteem is it
>> but people might be addicted to many
things and uh my wife's published many
papers on this and written a book and
this that and the other. Um and she
would say about 14% of the population
has some aspects of ultrarocessed food
addiction.
Um and
it kind of explained so much why are
intelligent people eating foods they
know do them harm. I've got another
example. One of my patients with type 2
diabetes, we got drug-free remission.
Hooray. I've done that now 157 times.
So, every one of them I'm cheering when
it happens. So, this guy, we did it.
Drug-free remission.
Then he vanished for a while and um
came back with two dead toes and he had
to have them amputated. Now,
>> dead toes.
>> Yeah. They started rotting because
diabetes takes the blood supply
particularly from your toes. So we had
to have surgery to have part of his foot
removed.
And so you call it carb creep and he
ended up with half his foot taken off.
That's not carb creep. Something far
more sinister.
But I never give up. And fortunately the
wounds took a long time to heal because
he was sugary. So we do it all over
again. I got him back into remission
because this time he and his wife are
really determined. But it's a struggle
and he needs help and support to achieve
that. He's not a foolish man. He's an
intelligent man and yet various foods
called to him. Eat me, eat me. And it's
very difficult for him to not. And that
I mean that's a very extreme example but
many people with overweight and some who
are not overweight are struggling
with very very significant carb cravings
and they really really uh struggle to
control them. There should be a button
just down below here and if it says
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our show, but you haven't yet hit that
button. Thank you so much.
>> For those people, and I assume there's a
lot of people, and actually some people
have seasons where they're in control,
they're out of control, they're in
control. You know, I've been there.
>> Um, what is step one today?
>> So, they're listening to you, they go,
"Fucking, I don't want to lose my toes
and all of these problems." What is step
one now?
>> Now, are we talking about for somebody
with type 2 diabetes or somebody who
can't control what they're eating?
>> Someone that can't control what they're
eating.
>> Great. Right. So, step one, we just did
it. I think step one is acknowledging
that is your problem. Because if you
don't, if you're not honest about your
problem, how are you ever going to sort
it out?
>> Honesty.
>> So, the first thing is honesty. And
that's very hard for people. All of us
have made excuses. You know, me and my
biscuits. I believed that the it was
easier for me to think that that was
stress and a reasonable reaction to the
stress of running a practice than it was
to say I've got a you know biscuits for
me it took me a year to give them up. A
year.
How pathetic is that? I was so driven it
took me a whole year.
>> How did you give them up? Um, I did it
by weaning myself off a bit like
methadone. So, I went from um I like
chocolate ginger biscuits and then I
went to digestive plane and then I went
to oat biscuits and then eventually I
went to almonds.
>> Why didn't you just do it all at once?
>> I should have done. And uh Jen Jen's a
great believer in cold turkey. Like what
is the thing? Stop it. I wasn't man
enough for that and it took me a whole
year. So the first the first thing is be
honest truth. Be honest with yourself.
Even if you can't tell other people, be
honest with yourself.
Is there an addictive potential there?
Could that be? Does that fit? Number
two,
specifically which foods is your
problem? And be honest.
Um because if you if you're not honest
then you number three is have a plan for
abstinence.
>> Mhm. Because if you if if there is an if
you have got an addictive potential
um
it won't be one biscuit and we all who
you know how many of us have said I'm
going to give up ice cream or biscuits
or pizza or whatever it is
>> and then you have a day and
>> you did or you have a drink or whatever
you think tomorrow
>> work stresses you out.
>> Yeah. Tomorrow tomorrow tomorrow. So
it's very important to be specific about
the foods and then to have a plan
for how you are going to do it. And
another thing is sometimes
it's helpful you know the people around
you that love you.
>> Mhm.
>> Maybe share with them
that it's it's that it's important and
that I need I might need some help.
Please be tolerant with me like
cigarettes. Please be tolerant if I'm
short-tempered. I'm going to try and do
this thing because it's important.
The difficulty, it depends whether the
person that loves you can be gentle or
if they're heavy-handed. If you confess
this and then they police you,
>> judgmental.
>> Yeah. It doesn't help.
>> Yeah. Yeah. Yeah.
>> What you're asking for is gentle support
and tolerance.
>> I can think of a time over my life where
I was with somebody Yeah.
>> and I was they were so into their
health. Yeah,
>> that it made me start to hide when I was
eating bad. I would
>> exactly thank you for that. That's
that's what happens. And you see that
people become
deceitful.
>> So the if you police somebody you love,
the result is deceit.
>> I was hiding the rappers of the things I
was eating.
>> Jen did that with me. She would uh she
she knew that I was monitoring. So she
starts hiding the rappers or then I'd
find them in the car
>> and and but then we have a situation
that we can no longer talk about it
because
>> so that if if somebody if you're forcing
somebody to become deceitful, you have
to back off a little bit.
>> Yeah.
>> Because that deceit
then affects self-esteem and that can
make them worse. And you didn't want to
make them worse
>> and then they're lonely because they
they can't share the bad days.
>> Yeah. It it's really good. I wonder
please could we show Jen's book at this
point?
>> Of course.
>> So, can I just explain the book? So,
this this is Jen's book. And the most
important thing is Jen doesn't make a
penny out of this book. So, it's fork in
the road with the idea that in your
journey, which one are you going to
pick?
>> Do you see?
>> So, it's fork in the road. She doesn't
make any money from this. Every penny
goes to a charity that she's set up
helping people with food addiction. It's
available on Amazon and self-published
on Amazon.
>> How How much does this book cost? It's
not a lot, is it?
>> It's about £15. Oh, no, it's less. I
think it might be 10 10 quid.
>> Okay, I'll tell you what I'll do.
>> Yeah,
>> I'll buy a,000 of them.
>> Fabulous.
>> And I'll put a link below in the comment
section. And so I all you've got to do
is if you've really enjoyed this
conversation and you'd like to get Jen's
book um
>> fork in the road.
>> A fork in the road. Maybe we can even
get some of them signed. Not all of them
cuz that hand get a couple of them.
>> Oh, that is brilliant.
>> Click below and um we'll send a thousand
of them out. And that's just a thank you
from from me to both you and Jen, but
also to the community who tune in for
these conversations. And it's so great
that people can get such simple
information that's so accessible and so
um rigorous in its scientific
credentials
um in a way like this that they can that
could change some people's lives.
>> Great.
>> Isn't that a wonderful thing? You know
that a simple book like this which isn't
long either. It's only
>> not a big read
>> could change some people's lives. That's
such a wonderful thing.
>> Steve, what you doing? Uh, just making
myself a delicious coffee
>> from the freezer.
>> From the freezer. Have you not heard
about Comtier?
>> No.
>> Oh my gosh. This is going to change your
life. I invested in this company called
Cometier last year and they're now one
of the sponsors of this podcast because
they've taken a pretty revolutionary
approach to making coffee. Every coffee
is precision brewed at 10 times the
strength and then they flash freeze it
with liquid nitrogen to lock in the
flavor and freshness. And then it's
delivered to you on dry ice in these
recyclable aluminum capsules, still
frozen, like a little ice cube. All you
have to do is pop the capsule out, add
some hot water, and then you stir it and
you are good to go. You can also make
delicious iced coffee drinks as well.
Just pour it in,
stir it up. And for anyone that hasn't
tried it, you can get $30 off your first
order of Cometier coffee if you go to
cometier.com/stephven.
I've done almost 700 interviews with
some of the most interesting people in
the world. And one of the things you
learn which is unexpected is that
vulnerability is the doorway to
connection. And after sitting here for 2
three hours with a guest, I feel a deep
sense of connection to them. And as they
leave, what I get them to do is to write
a question in the diary of a CEO. We've
taken all of the questions from the
diary of a CEO. We have put the question
here on this card with the name of the
person that wrote it. So you can sit at
home as I do with my fiance and my
colleagues at work and other people in
my life. Whenever we get a minute, we
play the diio conversation cards and it
is incredible what happens. These are
great if you're in a romantic
relationship and you want to connect
your partner more. These are also great
if you're in a team and you want to bond
your team together. And I have to say
they're also great for families that
want to learn more about each other and
that need a good excuse to spend some
time in a digital world in the analog
environment connecting human to human.
It is remarkable what the right question
at the right time can do. Go to the
diary.com
and you can get these conversation cards
right now.
You said something earlier on about the
link between
sort of your dietary choices and cancer.
I've actually got a friend of mine who
used to work for me who is going through
a cancer process at the moment. She's
very very young. She's actually younger
than I am. Wow.
>> And she was diagnosed with breast
cancer. She's a really good friend of
mine. Um and she was my actually my
manager for a couple of years. She's
called Katie.
>> She's very public about this. So she's
posting her journey online so I can I
can say her name. and um I've been
following her and she's she's you know
she's removing a lot of the the foods
we've talked about today from her diet.
So she's very front of mind for me at
the moment and I was looking at some of
the stats around the link between our
dietary choices and cancer outcomes and
I'm going to read them now. My team
might cut some of them out but I think
they're worth hearing because hearing
them I think is quite um enlightening. A
massive French study found that drinking
just 100 mil of sugary drinks per day,
which could be, you know, a third of a
can of soda is associated with a almost
20% increased risk of overall cancer.
Women who consume two or more dietary
drinks daily have over double the risk
of early onset calorical cancer compared
to those who drink less than one a week.
High consumption of sugary sweetened
beverages is linked to a 78% higher risk
of estrogen dependent endometrial cancer
in women. Drinking 20 ounces of sugar of
sugary soda daily is linked to
shortening your telomeres which are the
protective caps on your DNA equating to
4.6 Six years of extra biological aging
which is a major risk facilimia.
>> Chronic hyperinsulinemia.
Can I so that is when I'm saying when
the insulin levels are high which I
explained at the beginning
>> which can inhibit aptosis the natural
process where damaged or cancerous cells
self-destruct.
>> Wow.
>> Two more. Fructose is processed in the
liver and converted into lipids which
are fats which is what we were talking
about earlier which recent studies show
certain tumors directly consumed to
build their cell membranes. And lastly,
diets high in added sugars chronically
elevate C reactive proteins called CRPS,
an inflammation marker that is heavily
correlated with tumor progression and
metastasis.
>> Yeah.
So what I'd like to this is that is so
interesting and it brings to mind a
really important point.
We talk so much around the world about
treating cancer,
but what about prevention? Because for
your friend, that's a life sentence and
she's living with uncertainty and fear.
And when I tell patients they have
cancer, you know, you feel it right here
because you just took away so much.
And it's interesting. Do we try hard
enough? If we know that, are we trying
hard enough to prevent cancer? Because
that's what we should be doing because
we know a lot that I think after
smoking,
>> diet is the next commonest cause of
cancer.
And you know how serious does it have to
get when when you you just gave all
those references then and uh I know that
uh junk food is linked to all cause
mortality. It's linked to so many
things. Uh what what are we prepared to
sacrifice for enjoying you know treats
and snacks? It's kind of when you look
at it like that it's really bonkers.
Really bonkers. This sounds a bit crazy,
but sometimes I imagine receiving the
diagnosis.
>> Yeah.
>> And I do a bit of I guess they might
call it a premortem. Um a premortm, not
a postmortem, where I imagine on that
day the decisions I wish I would have
made. And I'm not saying all cancer is
linked to what we eat because that's not
the case. But I'm I'm imagining like the
worst diagnosis I could ever be given
and the doctor telling me that my
lifestyle choices contributed to that
over the last 5, 10, 15 years. And in
that moment, is there any sugary drink
that is worth it?
>> There's just no You would just wish with
every bone in your body where you come
home and tell your fiance, your partner,
your kids
>> that you've got this horrific diagnosis,
you would just wish
>> that you had made a different decision.
>> I also think that's a very good strategy
for dealing with problems.
>> You know, your life must be so
complicated. I can't begin to imagine
how many problems you're solving and the
complications and the people you deal
with. And yet all of them are as nothing
against a cancer diagnosis, aren't they?
So that you would look at the problems
you have right now and you'd laugh.
Yesterday I was worried about the
traffic or whatever and I think it's a
leveler. Mortality is a leveler. All my
life I've been obsessed with death and
it worries me. I can't sort out in my
head what does death mean or you know it
really scared me when I was a child the
idea of death but what it's given me is
a drive to not waste time and and to
think about what's the best use of today
and and you seem to have that kind of
energy as well. The interesting thing
about this idea of wasting time as well
is through everything you've talked
about today, we we can both waste less
time but also have more time. And when I
learned about the difference between
like lifespan and health span, that also
added to this equation. You know, people
still live to 80 years old, but
>> they're only healthy for like 30, 40
years.
>> And that's a very the idea of health
span is very important because we know
in the UK it's going down.
>> Oh, is it?
>> Yes.
Um uh it's it they're looking at that
now. Lifespan is hanging out there as
sort of stuttering along, but health
span is going down in the UK and it's
worth thinking why that is.
>> Well, I would hazard a guess it's uh
relates to all the things you've talked
about today.
>> I think it may do.
>> In England, you're totally right. It
says in England, the situation is
particularly alarming. Health span is
actively declining even as overall
lifespan slowly creeps up. Recent 2024
to 2026 data from the Office of National
Statistics, the ONS and the Health
Foundation paints a stark picture of the
UK's widening sick years gap. Over the
last decade, healthy life expectancy in
the UK has fallen by roughly 2 years. As
of the latest data, men in the UK can
expect to spend about 60 years in good
health and women about 60 years of good
health as well because overall life
expectancy in England is rising.
Um people are now spending roughly up to
23 years at the end of their lives with
poor health and in sickness. This means
the average person spends nearly a
quarter of their life managing chronic
illness and or disability.
>> And that's exactly the point, isn't it?
That's exactly the point
and it relates to another thing I'd like
to tell you about as well. This is um
government figures. Every taxpayer in
England pays an extra £7,000 tax per
year for the consequences of
ultrarocessed food.
>> Everybody's paying tax, extra tax,
£7,000 a year. And this is because it's
not just the cost of the drugs.
The bigger co bigger cost is this is the
people not paying tax themselves and not
able to work because they're ill. And
that is that's twothirds of the cost is
the lack of revenue because so much of
our population isn't well enough to work
and that's very and a lot of it's young
people too. It's very serious.
>> I know I think about 30 40% of our
listeners are in the United States. So
I've got some bad news for everybody in
the United States as well. The US how is
it there?
>> The US currently holds a rather grim
record. It has the largest health span
to lifespan gap on Earth. Despite the
United States having lower overall life
expectancy than almost all of its peer
nations and premature death rate that is
nearly twice the average of comparable
countries, its health span stats sit as
the worst in the world. So if you're in
the United States, as things stand, you
will be sicker for longer um or have
less We're trying to keep catch up
though, aren't we?
>> We're doing, you know, we're doing our
best.
>> We're doing our best, you know. We're
doing our best to catch up. Um,
>> I have this piece of string here.
>> Yes.
>> Which is, I guess, a mechanism you use
to figure out if people's
>> waste and I guess fat levels are too
high on the on the belly.
>> I think it's bigger than that. So, I'm
interested in lowcost ways for people to
find out well, how are you how are you
doing? How are you doing? And so one
recognized way looking at metabolic
health is your waist should be less than
half your height. So if we have a piece
of string, which we have there, I
believe you're 6'1.
>> Yes.
>> And you've you've marked halfway. So
half of that string
should go around the fattest bit of your
belly.
>> People come up to me all the time, you
know, and they go, "Oh my god, you're so
much taller than I thought."
>> Because they've only ever seen me sat
down. My entire career is people
watching.
>> That's right. Cut it in half and then
let's see.
>> Will it go around your belly? Yes or no?
>> Okay. So, I've cut the the string in
half.
>> Yes.
>> Which part of my belly? Cuz
>> the fattest part.
>> The fattest part. Okay.
>> Yeah. So, be honest about the fat part.
>> Okay.
>> Can I look?
>> Yeah.
>> You did it. Yeah.
>> Is that squeezing in?
>> It's not. No, I'm not.
>> Are you sque Are you cheating? Let me
see.
>> I mean, it's it's not it's Yeah, you've
just done it. You've passed. Thank you.
It's so interesting. So funny
>> but that is a very interesting thing for
you.
>> And as I say, insulin resistance tends
to put weight on your belly,
>> but you may have a very muscular
abdomen. Let's pretend it's that, you
know, but you're just about there.
You're just about there. But it's a
really simple test for everybody at
home. Piece of string, as long as you
are tall, cut it in half. Will it or
will it not go around your middle?
>> Okay. So, everybody at home, go buy some
string. Yeah, it's I mean there's lots
of other things you can do but that
that's as a simple way because your
weight alone as I said it's where the
fat is distributed it it's fat on your
belly is more worrying than fat on your
legs or on your arms really. So,
>> so one of the things people always ask
me about is supplementation. Um,
>> supplements, good, bad, indifferent.
What's your what's your point of view?
>> Right. So, my point of view is if you
can,
my my gut reaction is to try and use
diet
to give you what you need if you can.
>> Which diet? a lower a real food lowish
carbohydrate diet is my preferred thing
with plenty of protein in there and
healthy fats.
I'm very interested in farming and
regenerative agriculture and all that
kind of thing. And what I know is that
the nutrient profile of crops grown
today is not nearly as good as it was
100 years ago. So, we have some problems
and it it's to do with the soil. If you
keep just adding nitrogen and harvesting
crops, those crops do not contain as
much zinc or magnesium particularly.
And so,
the tragedy is that although my aim
would be to have you healthy with a real
food diet, there are some things you
cannot get in the diet now that your
grandparents could. And one of them is
magnesium.
It's very very difficult to get enough
magnesium
in your diet without supplementation.
And as you get older, you absorb the
magnesium
less and less. Also, a lot of medication
interferes with magnesium absorption,
particularly drugs for um acidity. So,
magnesium supplementation for most
people.
>> Okay. In myself, it was magic at getting
rid of muscle cramps. I sleep a lot
better.
I think we also need to talk about
magnesium. Which magnesium? Because it
varies a hell of a lot. And uh this
bit's embarrassing. Depends on your
bowels.
>> Okay.
>> Right. Have you got fast or slow bowels?
You don't need to tell tell me. If if
you if you tend to be a bit constipated,
magnesium citrate is very good. It
helps. It's more laxative
and it you're you absorb some of it.
Anyway, if your bowels are not a problem
and particularly if you're wanting
better sleep or mood, magnesium
glycinate or thriionate is actually
crosses the bloodb brain barrier but
won't help with constipation. So that's
a very quick thing on magnesium.
Have you have we got time for me to tell
you about the first cow I ever bought?
>> Go ahead.
>> And it's relevant to magnesium.
>> Go ahead.
>> Right. So my wife and I, my wife Jen, we
have this idea that if you love
somebody,
then gifts are you trying to think what
would that person like? Don't buy
somebody a present you would like.
>> Yeah. And it was Jen trying to get me to
grow up.
>> Yeah.
>> Right.
And this is how she did it.
So she said to me one day, "Right, get a
coat and a pair of Wellingtons. I'm
going to take you out." And she drove me
into Lancaster and there was a field of
cows. And she said, "I have bought you
any one of those cows." Because I'd
always wanted a cow. And we had a field.
and she'd how what a woman is this. She
knew I wanted she went to the farmer in
advance and prepaid for any cow and said
this field I've I I bought a cow. You
just pick which one you like and he'll
transport it home. How does this relate
to magnesium? You're wondering. Well, it
does because the farmer said you can
have whichever cow you like, but I've
lost 15 cows uh to a thing called the
staggers this year. And you cannot have
the cow unless you promise me you'll buy
magnesium supplements because the grass
is now so short of magnesium that uh
cows die fitting if you don't give them
a magnesium supplementation. But it's
better than that. At the same time, I
had a patient that I couldn't work out
why he was fitting. I was really fond of
this guy and I kept being called out and
admitting him to intensive care. fitting
and we couldn't work out. It wasn't a
brain tumor. Why was he fitting? And I
expect you've joined the dots. It was
magnesium deficiency because of
medication he was on.
>> And that's the first time I ever
seriously thought about magnesium. It's
a most interesting subject, very
important. And the modern diet is most
people are magnesium deficient. And a
problem is you can't measure it. So your
blood magnesium, the serum magnesium,
um doesn't reflect what's going on
because magnesium is mainly inside your
cells. So in the you have to get the
intracellular magnesium level. But do
you know what? It's just easier to try a
magnesium supplement and see how you
feel. So do you take magnesium?
>> I do because the guests, the experts on
my podcast have told me that magnesium
is one of my five. For me, I've said to
myself, I'll take five supplements a
day. Um,
>> five.
>> Yeah, I'll take five. So, vitamin D
because I'm inside all the time.
>> Vitamin D. So, yes, definitely.
>> And I'm black, so that you know,
>> well, that combined, but everybody and
particularly in the most people just
don't get enough sunshine. It'd be
better if you could do it with sun. But
yeah, vitamin D is very, very important.
>> I take magnesium.
>> Yeah,
>> because people like you've told me how
important it is.
>> Which magnesium do you take?
>> That's a great question. I think it's
citrate. Citrate, right? But I actually
think it varies depending on what my
team get me.
>> Yes. Yeah.
>> Um but that's good to know because I'll
think about my bowels. I take creatine.
>> Yeah.
>> Um there's this fiber supplement that I
take because I did a couple of blood
tests and um they said that fiber would
help this particular fiber supplement
would help reduce my LDL.
>> Yeah.
>> Cholesterol.
>> Yeah.
>> And
multivitamin
>> to cover everything.
>> To cover everything. That's probably I
mean that sounds okay really. Yeah. I
mean one of the worries that or one of
the clinical things I find is honestly
if you ask people how many supplements
they're taking there's a carrier bag
comes in and there's a blue one and a
yellow one and it is possible to overs
supplement quite easily
>> particularly maybe vitamin D. You can
know various uh vitamins. You handed
this as well. Oh that's vitamin D. Fine
fine.
So, I think that that's I would agree
with you. Basically,
>> mine's mine's also going um off my blood
test results. So, I've done two blood
test results. Actually, I've done two
blood test results in the last month.
>> One with Function Health, who are a
partner of ours, a sponsor of ours, and
another one with um with Nico Health,
which is actually a company that I've
just invested a couple of million quid
into, which is this health testing
company. Have you heard about Nico
Health?
>> Nico Health. You walk in, $299,
whatever. You lay down, you get all of
your your sort of blood test done. You
get all of these incredible tests done
on your body. Um, they show like how,
you know, how how good your circulation
is from your like neck to your toes. You
stand in front of this scanner. It takes
like 2,000 3,000 photos of your body,
tracks all of your moles, tracks your
heartbeat, does all of these incredible
things. And then instead of waiting two
weeks for the results, you walk into a
room and your entire body is on this
screen.
>> Yes. and you can look at, you know, all
these different parts of your body. They
do the blood tests at the very start and
then literally like it felt like 20
minutes later, I'm in a room. I've got
my blood test results back. I can see my
entire body. They're going through my
LDL, my this, my that, the other.
They're showing my heartbeat. They're
showing every single mole on my body.
And it cost £299. And you get the
results then. And I my alternative, and
this is me really plugging, the
alternative that I used to do every year
was this. Honestly, I'll be honest. It
was this £7,000 health screening where
I'd take it would take me six, seven
hours and I'd get the results back in 2
weeks. So, what Nico have tried to do,
it's actually a company started by the
founder of Spotify, Daniel. And yes, I
did my blood test the other day and both
my function health test and my my Nikico
health test said the same thing. And
then I took those results and I I
processed them using some AI tools and
said like, what am I deficient in? And
one of the things I was deficient in was
omega-3. That was the other one. uh
>> omega-3, vitamin D. I had high LDL
>> and so they said this fiber thing would
be really good for you.
>> And yeah, those were the main things.
Otherwise, I was great. But yeah, high
LDL.
>> I think one of just that makes me think
of something when you're screening. I
think the important point is that you
don't just scare people
>> that it has to be linked to what can you
do about it. So I've had a lot of
experience
>> of scared patients. Mhm.
>> So GPS, we we're we worry about
screening because what happens is people
do that and then people get scared and
use up loads of appointments in the
health service trying to sort out. So
what what's good is if you do screening
that relates to actionable points and
then you help the people understand what
they can do.
>> Yeah.
>> And avoid leaving them as just worried.
>> Exactly. Because that is for you,
>> you know, if if I can I might be able to
tell you accurately you're going to die
aged whatever of whatever, but if you
can't do anything about it, you don't
want to know.
>> Yeah.
>> What you do want to know is what can I
>> what can I take action on? What can I
you know, it's about optimizing, isn't
it? The things that I hate about the
health checking process before Nico was
like I hated how expensive it was and
that's quite it's quite a privileged
thing to be able to get health a full
body health scan especially like so but
now you can do it for $2.99 but then it
was I walked into a room straight away
with a doctor
>> and the doctor sat me down
>> beautiful screen of my body and was like
do this this this is fine this is fine
and she was so nice about it but yeah I
say that cuz I'm so passionate about it
cuz I realize there's a certain
privilege that people that are able to
access private healthcare have that I
think is really really unfair.
>> Well, obviously I
>> I think that's unfair because I only
work in the health service.
>> Yeah.
>> The state self. I don't do anything
other. I won't take private patients or
because
>> I think it it would be wrong.
>> And because don't you think health
inequality is getting really bad?
>> Yes, exactly.
>> Really really bad.
>> And it kind of troubles me. And also if
you you start in the UK and you go
northwards, it just gets worse and worse
and and the states is the same where
it's not like the same nation.
>> Oh my gosh, it's you go to California,
there's one kind of a thing and then you
go elsewhere and it's not the same.
>> But hopefully this is changing. Um this
is I I I
>> Well, I think social media helps because
it doesn't cost much, does it, to go on
social media and find out things.
>> Exactly. and people like you who have um
increasing increasingly loud voice
across lots of podcasts and who are
reaching millions and millions and
millions and millions and millions of
people um and teaching them.
>> What's difficult though is not to become
confused,
you know, because you have the
newspapers saying eggs are good, eggs
are bad,
and then you have this expert who's
saying this and another expert saying
the other. I think what I've tried to do
is base what I say on real world data
and that's different. So I'm I'm very
careful to take baseline data from my
patients and then update it all the
time. So what I'm the publications I've
done are based
on the real world the health service in
the north of the UK. I can't cherrypick
my patients. I'm allocated my patients
by the state. So I I can't just pick
wealthy people or people that will live
longer. I'm allocated people and that's
that. So
part of what I do is proof of concept
because if you can achieve this in the
north of England near Liverpool and if
other people can replicate it in
Australia, New Zealand, North America,
maybe it's true
perhaps.
>> Dr. David Unwin, we have a closing
tradition on this podcast where the last
guest leaves a question for the next,
not knowing who they're leaving it for.
And the question left for you,
>> yeah,
>> is I'm sure the guests will figure out
who left this one. Um, if humanity
organized to make contact with a more
intelligent species,
>> yes.
>> Who should represent humanity and why?
>> Funny. God, that's a brilliant question.
Who should
The first person, this is a person I'm
going to nominate.
What about David Atenburgh? you know,
he's 100 years old and he spent so long
um thinking about the planet and
wouldn't he be a wonderful ambassador
and because I am passionate about
biodiversity, I'm passionate about
sustainable
agriculture and sustainable food. I pick
David Atenburgh.
>> I think that's a wonderful choice.
>> I think the aliens would really like
him.
>> They would. They would. That's my
answer.
Thank you so much for what you do. Um,
you're really remarkable in a way that's
quite rare. And listen, I would know
because I
>> Give me feedback. I love feedback.
>> No, you really are remarkable. You're
really remarkable in a way that's very
rare. And I don't say this to all of my
guests, but you are for for a variety of
reasons. Okay, I'm going to give you all
of the feedback.
>> Thank you.
>> The first the first the most notable is
you're a very kind human and the way
that you speak is very nice to listen
to. Again, rare. The other thing that I
noticed is you're very very very natural
and good at telling stories. And listen,
why does this matter? Because the human
brain, from what I've discovered from
doing this podcast, is really orientated
towards stories. Now, you could sit here
and say banana bad or you could say
magnesium good, but I'll never forget
the cow story.
>> Yeah.
>> You know, I'll never forget the cow
story. I could have I could have
forgotten that magnesium good, magnesium
bad, but the way that you tell these
stories is so captivating that it
enables me to learn in a way that is
engaging and that is rare, very very
rare. And the other is just um your your
depth of experience, your humility, your
willingness to admit when you were
wrong, which means that I trust you so
much with what you're telling me because
you're you're saying, "Listen, I'm I'm
an imperfect human, too. I've made
mistakes both in myself, with my
patients, and this is what I've learned
from it." And um the other thing is just
your ability to simplify. It's
remarkable. Listen, I sit here all day
with super geniuses from this university
and Harvard and Stanford and whatever
else and I'm struggling to understand
what the hell they're talking about
because they don't take a second to
build the bridge between the science and
the average person and you do that so
naturally. So I I have no I have no
surprise
>> coming from you that means a great deal.
No, it really does. Thank you. It's just
what 40 years in general practice does
to you. Because if you wish to be
effective and if you notice as in the
grin model,
>> I'm I'm watching your face.
>> I'm watching an audience
>> and I'm reading how I'm doing or you're
getting bored or I need to move on or
whatever. And that's what I do with
patients. I watch very carefully.
>> But coming from you because you really
do know because you've had all sorts. So
that means such a lot.
>> It's a really rare skill. actually
because it's so rare, I would just
implore you to do more. And I know
you're already doing so much, but it's
like it's so rare that you can have such
a massive impact.
>> Yeah.
>> You know, so I really I really wish
>> But we need to talk about how the how we
so I'm trying to get bigger on Twitter,
so this will help me um immensely.
>> Um
>> well, how can the audience help how can
the audience help you with your mission?
Well, lowcarbgp on Twitter. Please
follow me on X, lowarb GP. Yeah.
>> The other thing that would help very
much is to support the British charity
that I set up, the public health
collaboration. Um, it's our 10y year
anniversary. We set up, these were
clinicians who got together, 16
clinicians said, "How we doing rubbish?
Can we do better? Can we give clearer
public health advice?" So, it's called
the public health collaboration. So,
please, please support our charity. Go
online, find out about it. Come to our
conferences. I'd also say notice
each of us is on a journey. Be clear
about your goals.
Notice what works for you because that's
what you're doing.
>> And each of us see yourself as an
experiment. Don't be frightened of
experimenting. But if you're going to
experiment, notice, measure something,
measure something, and then you'll see
how you're doing. Um, and I I one thing
I think that gives me hope is continuous
glucose monitors because
you're getting, you know,
individualizing right there. How is my
blood sugar? I can check mine in a
minute and see how I'm doing. I think
continuous glucose monitors
>> which by the way are only 20 $30 on on
Amazon or
>> Yeah. I I would think you know what if
you loved your dad or you had somebody
and it's Christmas and you could buy a
useless
ornament or something and they don't
need it anyway. But would they be
interested to find out about their blood
sugar?
>> Yeah. You could maybe consider, you'd
ask them first, but if they've if
they've got a mobile phone, they could
try a continuous glucose monitor and
find out. Have you Have you tried one?
>> I have. I have.
>> And what did you learn?
>> I mean, so much.
>> Ah, well, did you learn? I learned that
all these things I thought were were had
no sugar in them have loads of sugar in
them.
>> Exactly.
>> I had no idea about ketchup. I thought
it was
>> And the point is once you've seen it on
your phone,
>> you can't then see it.
>> No. And I see them as the the cavalry
coming over the hill because we can't be
fooled much longer. Do more. I'm just
going to look at see what my blood sugar
is right now.
>> So, can I just show you?
>> Oh, wow.
>> So, what that is, that's somebody with
type 2 diabetes. But look, my blood
sugar is absolutely level.
>> Wow.
>> And that's good. uh because
you want it. But look how how level it
is. And that is because I don't eat
stuff that puts up my blood sugar. If I
was to have some of those, you'd get a
um you get a spike. But that's feedback.
Also means if I get very stressed, it
puts up my blood sugar. Really? And
you've been so kind. I haven't been
stressed.
>> Great. Thank God for that.
>> So other podcasters
>> are not as gentle and kind as you and I
get a horrible spike. So, I was going to
open. Here's some feedback for you,
Stephen. So, you and I have been
together for a few hours, and my blood
sugar I felt safe. So, you've done your
job, too. And there's some feedback for
you. No spiking.
>> I'll tell you a final story. A final
story.
>> Um, so type 2 diabetes is is brand new
as a problem for pediatricians.
>> What is a pediatrician? So a
pediatrician is a doctor who specializes
in the diseases of children, people
under 16 years old. And the the the
international problem is that children
everywhere are now suffering from type 2
diabetes.
Okay. But the pediatricians have had no
training because it's a new disease.
So um a large group of pediatricians
sent for me and said please do a keynote
and teach us what to do because they
although they're specialists they
haven't experience in type 2 diabetes.
This is a new disease of children
what we're doing what we're doing. Leave
it at that. We didn't show the fuagra
but
I'll eat some of that later.
>> Dr. David Unwin, thank you. We're done.
>> Fabulous. I enjoyed that.
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