Video:Hacking the American Mind by Dr Robert Lustig
Transciption

Okay thank you I'm just the messenger,
0:10 Jill. Thank You Jana, thank you for that
0:14 kind introduction. Thank you for inviting
0:16 me. I also want to thank Melissa Riley
0:17 who works at the West Portal branch of-
0:20 Oh yes there you are- at the SFPL for
0:24 suggesting that we have this discussion
0:27 tonight and I got to tell you I love
0:30 the SF public library and so should you.
0:34 And the reason I love it is because they
0:38 have fiction and they have nonfiction.
0:45 But there's one thing they don't have.
0:48 They don't have fake news. Which is
0:55 fiction masquerading as nonfiction. But
1:00 tonight we're going to talk about the
1:01 fourth group, that is the nonfiction that
1:05 masquerades as fiction, and what I'm
1:11 going to argue is that you're all caught
1:15 in the matrix; a fictitious assembly of
1:21 things that you don't know about that
1:23 have been hidden from you; and I'm going
1:25 to try to expose that over the course of
1:28 the next hour and a half. So I do have
1:33 some disclosures. I did write these two
1:37 books, one we're talking about tonight. I
1:40 am the chief science officer of this
1:43 nonprofit called Eat Real which
1:45 certifies restaurants, hospital
1:47 cafeterias, schools that serve real food
1:52 with the idea that by doing a bottom-up
1:55 effort we can actually teach people what
1:59 is real food and try to get processed
2:02 food out of our lives because that's
2:04 where the big problem is; and also I am
2:07 the chief medical officer of a
2:08 for-profit company called Slendy which
2:11 is developing
2:13 specific products to try to mitigate the
2:16 metabolic risks associated with
2:18 processed food because as much as I
2:20 would like it processed food ain't never
2:22 going away because there's just too much
2:25 money involved but as long as health
2:28 hangs in the balance we have to do
2:30 something to try to mitigate it we have
2:32 some ideas on how we might be able to do
2:34 that and so that's a for-profit company
2:37 and I, you know, stand by that. Okay so
2:41 that's- those are my disclosures. So
2:42 I have a very modest agenda tonight.
2:47 Hopefully by the end of the evening we
2:50 will solve the healthcare crisis, solve
2:55 the social security crisis, solve the
2:59 opioid crisis, solve the depression
3:03 crisis, which no one's talking about, and
3:07 make America happy again. Okay so we'll
3:14 start here. Let's start with health care.
3:16 Anybody know this guy?
3:18 Anybody ever seen him before? That's
3:21 right- Ezekiel Emanuel, brother of Rahm
3:23 Emanuel mayor of Chicago. Sorry? I don't
3:30 know that. He's at University of
3:32 Pennsylvania he's a bioethicists and
3:34 hematologist oncologist and he's also
3:37 the architect of Obamacare. That's right.
3:39 Well he wrote this article in the
3:42 Atlantic three years ago now "Why I hope
3:46 to die at 75" because he had to justify
3:49 why Obamacare. Now to be honest with you
3:54 if you read this article it's pretty
3:56 horrible. And the reason is horrible is
4:00 because he misses the entire point. Not
4:03 once in the entire article is the word
4:05 "diet" ever mentioned. We're gonna spend a
4:09 lot of time on that as we go through
4:11 this, okay. So I hope not to die at 75. I
4:16 hope to die much later and hope be much
4:19 healthier than our current 75 year-olds
4:23 are and the reason is because I
4:26 think I understand what's going on and
4:29 I'm gonna try to convey that to you
4:30 tonight.
4:31 So the question on our minds is did
4:34 Obamacare deliver? *to audience-sorry move it closer
4:39 oh okay because I is is that better okay-*
4:43 Did Obamacare deliver? so Obamacare
4:48 promised to put thirty two million sick
4:50 people onto the rolls, and believe it or
4:53 not it's still the law of the land
4:54 although the individual mandate is now
4:56 gone which is going to create major
4:57 problems. The point is that President
5:00 Obama told us that we could pay for this
5:02 by providing preventative services; That
5:05 is by having everybody have access to
5:08 medical care to their doctor; that we
5:11 could keep people healthier and out of
5:13 the emergency room where costs are fifty
5:15 times higher. That's the idea. So that
5:19 creates cartoons like this. "The
5:21 government can't make me buy health
5:23 insurance and why would I when I can just
5:25 go here and you'll pay for it", and now
5:28 that we've lost the individual mandate
5:30 because of the tax reform bill in fact,
5:34 we'll be paying for it. Okay? We will be
5:37 paying for it because now they won't be
5:39 paying for it. So even worse. Well here's
5:44 the fallacy of Obamacare. In fact we
5:48 didn't keep a people out of the
5:49 emergency room there's been an actual
5:51 uptick in emergency room visits to the
5:54 point where health care plans had to
5:56 increase their premiums by over 25
5:58 percent and three of the insurers left
6:01 the exchanges entirely, Aetna, Humana and
6:04 United which of course led to the
6:07 election of 2016. I think you all
6:09 remember that, wasn't that long ago. Okay.
6:13 In fact if you look at what's going on
6:18 in terms of the dollar amount it's been
6:21 enormous. A 100 billion dollar increase
6:24 per year in just four years just for
6:28 diabetes alone never mind
6:30 everything else. And 75% of all the
6:34 healthcare dollars spent in this country
6:36 are for chronic metabolic disease. So you
6:38 can see this is breaking the bank
6:40 and if these people don't have to even
6:42 pay for the individual mandate how in
6:44 the world are we going to be able to
6:45 provide health care? Trump Care, which is
6:51 not really there but is really there,
6:55 ultimately says this because this is Nik
6:57 Mulvaney OMB director who says "got
7:01 diabetes your fault, you brought it on
7:04 yourself no health care for you" like the
7:06 Soup Nazi. The point is that this is
7:13 predicated on two inconvenient truths
7:16 that no one wants to utter but I'm gonna
7:19 utter them. The first is there is no
7:23 medicalised prevention for chronic
7:25 metabolic disease.
7:26 There's only treatment. There's treatment
7:29 for hypertension, there's treatment for
7:31 high lipids, there's treatment for heart
7:32 disease, there's treatment for type 2
7:34 diabetes but there's no prevention.
7:35 No-one's talking about what it takes to
7:38 prevent those diseases and until we
7:39 prevent them, we can't afford them. This
7:44 is a meta-analysis of type 2 diabetes
7:47 prevention strategies that just came out
7:51 about a month, two months ago now, okay,
7:54 and if you look at the diamond over here
7:56 okay it is to the left of the identity
8:00 line which means that it is
8:01 statistically significant. These
8:03 prevention strategies work; whether it be
8:05 a lifestyle or whether it be drugs.
8:09 Here's the problem; here's the relative
8:12 risk for lifestyle; here's the relative
8:14 risk for medicines. So you say well
8:16 that's good. These things work. But here's
8:19 the real problem the number needed to
8:21 treat the NNT which is the really
8:24 important thing 25 you have to invoke
8:28 treat or prevent 25 different people to
8:33 be able to prevent one of them from
8:35 going on to develop diabetes and
8:37 currently we have a nine point four
8:40 percent diabetes rate and a 40 percent
8:43 pre-diabetes rate in this country. If we
8:47 have a number needed to treat of 25 for
8:50 these strategies, we ain't never going to
8:52 catch up.
8:53 That's what this comes down to.
8:56 Irrespective of whether these things
8:58 quote "work or not" we can't do it.
9:04 The second inconvenient truth is you
9:07 can't fix healthcare until you fix
9:09 health. And you can't fix health until
9:12 you fix diet. And you can't fix diet
9:15 until you know what the hell is wrong.
9:18 And that's where I came in. What the hell
9:22 is wrong? So this is what we thought was
9:26 wrong. Everybody remember this: 1984, it's
9:32 all about dietary fat, all about
9:34 cholesterol all about heart disease- get
9:37 your cholesterol down, everybody said get
9:40 rid of the saturated fat etc etcetera.
9:43 You know that story. Ok, so we did it and
9:47 this is what happened instead. This is
9:50 the unintended consequence and this was
9:53 from 2001 is now 2018 and it is 20 times
10:00 worse. Here's the fiction: it's on this
10:04 slide- any of you watch football? Ok about
10:08 five years ago this was on every
10:10 football game, every telecast. One of the
10:13 commercials from Coca Cola a two-minute
10:15 video called coming together and this is
10:18 a direct quote from that video. It said
10:21 "Beating obesity will take action by all
10:23 of us based on one simple common-sense
10:26 fact: all calories count no matter where
10:30 they come from including Coca Cola and
10:33 everything else with calories"
10:35 Direct quote. So as far as they're
10:38 concerned you can get your calories from
10:39 carrots or you can get your calories
10:41 from cheesecake get your calories from
10:43 Coca-Cola or you can get your calories
10:45 from kumquats. Done that, because it's the
10:49 first law of thermodynamics which says
10:52 energy can neither be created nor
10:53 destroyed just shifted around, which in
10:56 human terms means energy balance,
11:01 therefore it's about calories in,
11:04 calories out.
11:06 Therefore it's about diet and exercise,
11:10 therefore if you're fat it's your fault,
11:13 because these are two behaviors that you
11:15 are presumably in charge of yourself,
11:18 therefore any calorie can be part of a
11:21 balanced diet, therefore don't pick on
11:24 our calories go pick on somebody else's
11:26 calories. All that comes from this simple
11:29 mantra that a calorie is a calorie and
11:31 after all it's common-sense. Well I don't
11:36 believe in common-sense. I believe in
11:39 science. I believe in data. At UCSF we
11:42 have a motto "In God We Trust, everyone
11:45 else has to produce the data". That's
11:48 called truth as opposed to post-truth
11:54 which is what we have now. And who is it
11:58 that's been saying that a calorie is a
11:59 calorie? Well these guys. Familiar with
12:02 all of them, right? They control 90% of
12:06 the world's food. 90%. So they'll tell you
12:12 it's about calories, it's about obesity.
12:14 You get fat, you get sick. You get fat
12:19 because you're a glutton and a sloth. All
12:23 your fault. That's what they say. So the
12:27 question is, is that true? What do you
12:29 think? What does the science say? So on
12:34 this slide we have a scattergram: Obesity
12:38 prevalence country-by-country on the
12:41 x-axis, and diabetes prevalence
12:43 country-by-country on the y-axis and you
12:46 would look at this scatter gram you say
12:49 "Well very clearly Dr. Lustig there
12:50 there's clearly a correlation and there
12:53 it is" and indeed there is a correlation,
12:55 and I don't argue that this correlation.
12:57 But correlation is not concordance.
13:00 They're not the same because we have
13:03 countries that are obese without being
13:06 diabetic such as Iceland, Mongolia,
13:08 Micronesia. We also have countries that
13:11 are diabetic without being obese such as
13:13 India, Pakistan, and China. India and China
13:16 today have an 11% diabetes
13:19 rate. We the fattest nation on earth
13:22 have a 9.4% diabetes rate. If it's about
13:26 obesity, how come the non-obese countries
13:30 have more diabetes than we do? First
13:34 problem. Second problem: obesity is
13:39 increasing worldwide by the rate- the
13:42 annualized amortization rate- of
13:45 2.78 percent per year over
13:48 the past 40 years, yet diabetes is
13:52 increasing at the amortization rate-per-
13:55 year of 4.0 percent for
13:59 those same years. If diabetes is just a
14:03 subset of the larger subgroup of obese
14:06 persons, then how can you explain the
14:09 fact that the diabetes rates going up
14:11 faster?
14:12 Well you can't because, ah, maybe it's not
14:17 true? And finally, here's another piece of
14:22 data. This is from JAMA and it's looking
14:25 at the secular trend over time in
14:27 diabetes cases in the United States.
14:29 Here's the total here and we're gonna
14:32 look at the right side here first, okay.
14:34 So here is the rate of increase in the
14:37 obese population- a 25% increase in
14:41 incidents per year within the obese
14:43 population however there's also been a
14:45 25% increase in the incidence in the
14:48 normal weight population - if diabetes
14:52 is really about obesity how come the
14:55 normal weight people are getting it just
14:56 as fast problem number three this does
15:03 not compute so this is the most
15:07 important thing I'm going to tell you
15:08 tonight here we have a Venn diagram of
15:12 the entire US adult population
15:15 okay 240 million total 30% obese in this
15:21 circle that's 72 million 70 percent
15:25 normal weight 168 million mutually
15:30 exclusive circles, everybody got that?
15:32 Everyone is in this,
15:33 in one of the two circles, you got that?
15:35 Right, okay, BMI over 30, BMI under 30.
15:40 Everybody's in one of them. So here's the
15:45 problem: the medical profession,
15:49 the dietary profession, the Institute of
15:53 Medicine, the National Institutes of
15:56 Health, the Surgeon General, the White
15:58 House, Congress, and the food industry say
16:03 the follower 80% of those obese people,
16:09 80% of those people with a BMI over 30,
16:13 these 57 million people,
16:18 they're sick, they're fat, and they're
16:23 sick. And they're sick because they're
16:26 fat and if they would only just diet and
16:29 exercise we could solve this problem.
16:32 That's what they say- garbage, total
16:38 complete trash. Everyone except me. Why is
16:46 it garbage? It's on the slide. Well it is
16:50 true that 80% of 30% are metabolically I
16:54 don't argue that but that means that 20%
16:59 or not 20% are obese and healthy we
17:04 actually have a name for them. An H Oh
17:06 metabolically healthy obese we study
17:09 them to try to figure out how come they
17:11 didn't gets it they will live a
17:13 completely normal life, die at completely
17:15 normal age, not cost the taxpayer a dime,
17:18 are not the problem of Obamacare they're
17:22 just fat.
17:24 Conversely, and this is the important
17:26 part, 7 the 40% of the normal weight
17:31 population 40% of 70% have the exact
17:34 same diseases for the exact same reason
17:38 as did the obese they're just not obese,
17:41 they get type 2 diabetes, they get
17:43 hypertension, they get the lipid problems,
17:44 they get cardiovascular disease, they get
17:46 alzheimer's, they get dementia, too. Now they
17:49 don't get it at the same prevalence.
17:51 Eighty percent versus forty percent so
17:54 obesity is without question a risk
17:56 factor,
17:57 I don't argue that, okay, if you're obese
17:59 you have a much greater chance of being
18:02 sick than if you are normal weight. I
18:04 don't argue that, that's true but turns
18:09 out when you do the math there's
18:11 actually more thin sick people than
18:16 there are fat sick people and these are
18:21 the ones who are saying it's their
18:22 problem and when you do the math on the
8:25 whole thing it's more than half the U.S.
18:28 population which is what makes this a
18:30 public health crisis and
18:33 if thin people get it too how can it be
18:38 about behavior they're not eating too
18:42 much in exercising too little because
18:44 their normal weight this does not look
18:47 like behavior this looks like exposure
18:51 this looks like cholera or influenza or
18:55 tuberculosis or something like that.
18:56 Now I'm not saying it's an infection but
18:58 it is an environmental exposure. The
19:03 question is what is the exposure that
19:05 explains this how do thin people get
19:08 sick - with the same chronic metabolic
19:11 diseases that the fat people get? That's
19:16 the question for tonight and that's the
19:19 question that no one in the medical
19:21 profession and no one in Washington is
19:24 even asking or answering. And that's
19:27 the fiction, and I'll prove it to you.
19:33 So here are two equally weighted people.
19:37 Notice trunk fat 12.8 right there, okay,
19:40 equally weighted people, one of these
19:43 people is healthy, one of these people is
19:45 sick. Which one's the sick one, A or B? I
19:50 heard both. B is the sick one.
19:56 Hey he's just got big love handles, not a
20:00 subcutaneous fat or big but fat if you
20:03 will, okay.
20:05 Turns out big butt fat isn't
20:06 particularly dangerous might be
20:09 unsightly in a bathing suit but not
20:11 particularly dangerous whereas this guy:
20:14 He's got fat all around his organs,
20:16 intra-abdominal fat, he's got a visceral
20:19 fat, big belly fat, and everyone will tell
20:24 you big belly fat's worse than big butt
20:25 fat, yet they're equally weighted and we
20:28 have a name for this it's called tophi
20:31 tof i thin on the outside fat on the
20:34 inside real medical term swear to God
20:37 1500 MEDLINE citations go look it up and
20:42 it turns out it's not even the visceral
20:45 fat it's worse than that it's even
20:47 deeper than that.
20:48 So here is a metabolically healthy obese
20:52 person, mhm, oh okay no joke, so they're
20:56 the love handles you see those now I
20:59 want you to take a look at this guy's
21:00 liver right there nice and dark notice
21:04 dark 2.6 percent fat that's actually
21:07 pretty good
21:08 okay this guy has MHO this is a healthy
21:11 obese person with a low liver fat. Now
21:17 here's another fat fraction map on
21:20 somebody who has metabolic syndrome now
21:23 he has obesity you can see the love
21:24 handles there take a look at his liver-
21:26 24% liver fat. This guy's got all the
21:30 metabolic diseases that you know about,
21:33 type 2 diabetes, fatty that's fatty liver
21:36 that's what that is.
21:37 Okay everybody would think foie gras,
21:39 okay no difference, okay and it looks the
21:44 same. Looks the same under the microscope.
21:46 It looks the same in the autopsy pen,
21:49 okay, it looks like foie gras. Well here
21:53 is a thin person. Notice not too much in
21:57 the way of love handles there but take a
21:59 look at his liver 23% this person is
22:02 just as sick as the person in the center.
22:05 Thin thin sick fat sick fat healthy.
22:09 So my question to you sitting there now:
22:15 Are you at OFI do you know how would you
22:23 know, would your doctor know, how would he
22:29 find out or she find out? That's what
22:34 we're gonna talk about so maybe you'll
22:36 teach your doctor something which would
22:38 be very good because most doctors don't
22:39 know too much as I have found out the
22:43 hard way.
22:44 In fact the fat hypothesis has actually
22:48 been debunked and who debunked it first?
22:51 The American Heart Association. Yet if
22:54 you go to the American Heart
22:56 Association's website today it's still
22:58 up there. So this is from Ron Krause who
23:02 is just across the Bay Children's
23:04 Oakland Research Institute head of the
23:06 nutrition committee the AHA who they
23:10 have debunked it but the AHA was so
23:14 invested in this message they're having
23:17 a hard time walking it back. Now they are
23:19 walking it back and I was actually a
23:21 member of the board of directors of the
23:22 Bay Area
23:23 AHA and I'm proud to say that we have in
23:26 fact walked it back but not every
23:29 society has for instance the American
23:32 Diabetes Association has not walked it
23:34 back in fact they're still saying the
23:36 same old thing so who do you trust? Who
23:43 do you trust?
23:44 Do you trust doctors or do you trust
23:49 bankers?
23:52 I trust bankers and the reason I trust
24:00 bankers is because they only have one
24:05 directive to make money and they want to
24:09 know what's going on in order to make
24:11 money and so they can look at data with
24:14 a clear eye without the bias that has
24:17 come with the last 40 years and that was
24:20 what happened at this with this report
24:23 quote Credit Suisse Research Institute
24:26 and it's called that the new health
24:28 paradigm and they looked at all the data
24:31 without medical bias and here's what
24:35 they said:
24:36 "A high intake of Omega-6 fats as
24:40 vegetable oils has not been proven as
24:42 beneficial for our health and trans fats
24:45 have been shown to have negative health
24:47 effects the higher intake of vegetable
24:49 oils and the increase in carbohydrate
24:51 consumption in the last 30-40 years are
24:54 the two leading factors behind the high
24:56 rates of obesity and metabolic syndrome
24:58 in the United States" saturated and
25:00 monounsaturated fats are not exactly
25:04 right.
25:05 Couldn't agree more. Absolutely. 100%. And
25:11 I had nothing to do with this report
25:14 okay, the bankers got it right because
25:17 they looked at all the data and analyzed
25:19 it without a bias because they won't
25:22 know who to invest in. In fact doctors
25:27 are coming around and this is a
25:30 editorial that was in JAMA I started on
25:33 British journalist horse medicine sorry
25:35 the another one coming from John written
25:37 by my colleague Essene Malhotra who is a
25:41 member of the NHL's NHS Health Trust in
25:43 Britain read a read Berg who's here at
25:46 UCSF who is the editor-in-chief of JAMA
25:49 internal medicine and also Pascale Meyer
25:52 who happens to be the editor-in-chief of
25:54 BMJ open heart not exactly lightweights
25:57 and they came out and said saturated fat
26:00 does not clog the arteries coronary
26:03 heart disease is a chronic inflammatory
26:04 condition
26:05 the risk of which can be effectively
26:07 reduced by healthy lifestyle
26:09 interventions. I couldn't agree more.
26:11 It's not about the saturated fat. 40
26:15 years of saturated fat being taken out
26:20 of our diet and all we did was get
26:23 sicker.
26:26 In fact the saturated fat is irrelevant.
26:29 It does have to do with Omega-3s and
26:31 Omega-6s. I don't argue that. We're going
26:33 to talk about that in a little bit it
26:35 has to do with sugar and refined
26:38 carbohydrate which drives insulin
26:41 resistance and systemic inflammation and
26:43 we think we know actually what the
26:45 compound in the liver that causes this
26:48 is but I'm gonna not tell you because we
26:50 haven't proven it yet but we think we
26:52 know and that's what's driving all of
26:57 this but that's not what we've been told
26:59 and it's still not what several
27:02 societies such as the American Diabetes
27:04 Association is saying today so who do
27:07 you trust?
27:09 In fact we wrote this editorial that
27:12 came out two months ago: The cholesterol
27:16 and calorie hypotheses are both dead.
27:18 It's time to focus on the real culprit:
27:20 insulin resistance. The fact that
27:23 insulin levels are high but the insulin
27:27 is not working and because it's not
27:29 working the pancreas has to make extra
27:30 and it turns out the insulin itself is a
27:33 bad actor in this story the goal is to
27:36 bring your insulin levels down and how
27:39 do you do that? Well you get rid of the
27:42 fatty liver and how do you do that?
27:46 That's where we're going, okay everybody
27:49 with me, turns out that fatty liver is
27:53 worse than fat anywhere else in your
27:57 body and the reason is because that's
27:59 the organ that the insulin works on is
28:02 the liver. Anybody knowing in anatomy and
28:06 it turns out the pancreas drains right
28:09 into the liver. Now the rest of the body
28:12 it goes artery organ vein heart
28:19 but there are two places in the body
28:21 where COEs artery organ vein ii organ
28:26 ii vein heart' series okay it's called a
28:32 portal system. There are two portal
28:33 systems in the body one is hypothalamus
28:36 pituitary and we know why that is that's
28:38 as an endocrinologist, that's what I do,
28:39 and pancreas liver also endocrinologist,
28:43 that's what I do, the reasons because
28:45 delivers the primary target of insulin
28:47 action and when your liver is sick you're
28:51 sick and that liver fat that I showed
28:54 you before it's the driver and what is
28:57 the driver of the liver fat? Sugar, sure
29:03 and that's what we have shown in a
29:06 series of papers that have come out over
29:07 the last couple of about year and a half
29:10 now and you've probably seen them
29:12 reported in The New York Times, The
29:13 Washington Post and you know on TV and
29:16 for good reason, okay. These are the three
29:19 papers that we've had in obesity,
29:20 atherosclerosis, gastroenterology. And
29:22 here's what we've shown: So when you
29:27 consume a lot of sugar you end up with a
29:29 lot of liver fat and you also end up
29:33 with a lot of triglyceride in your
29:35 bloodstream called VLDL very low density
29:37 lipoproteins. Now your doctor ignores
29:39 those because he doesn't know what to do
29:41 with them and he doesn't even know where
29:42 they came from.
29:43 Everyone thinks LDL is the problem turns
29:46 out LDL is not nearly as dangerous as
29:50 VLDL. The LDL has a hazard risk ratio for
29:55 heart disease of 1.8 VLDL has a hazard
29:59 risk ratio for heart disease of 1.3 so
30:03 it's at least 50% more dangerous and
30:07 probably more and your doctor isn't
30:10 doing a damn thing about it.
30:12 He's not even telling you about it and
30:14 he doesn't know what to do, she doesn't
30:16 know what to do about it.
30:17 And that's what we're talking about, okay.
30:20 So, what we did was we took 43 kids from
30:24 our clinic at UCSF who had metabolic
30:27 syndrome that is obesity plus at least
30:29 one of these comorbidities. What we did
30:32 was we
30:32 figured out what they were eating at
30:34 home on their normal diet we studied
30:36 them on that normal diet and then for
30:38 the next nine days we took all of the
30:42 added sugar out of their diet.
30:45 We reduced their dietary intake of sugar
30:48 from 28% of calories to 10% of calories.
30:53 We got rid of all of the refined sugar,
30:58 got it? Now if you do that you're gonna
31:01 reduce the total caloric intake by 350
31:04 to 400 calories and if you do that then
31:07 well people might lose weight and if
31:10 people lost weight at least kids lost
31:11 weight then people say well of course
31:12 they got better they lost weight. So we
31:16 didn't want them to lose weight we
31:18 wanted them to stay the same weight so
31:20 we took the 340, 350 to 400 calories out
31:24 of the diet as sugar and we put it back
31:26 in as starch. So in the vernacular we
31:30 took the pastries out we put the bagels
31:33 in. We took the sweetened yogurt out, we
31:36 put the baked potato chips in. We took
31:39 the chicken teriyaki out we put the
31:40 turkey hotdogs in. Everybody got it? We
31:44 can give him good food, we give him
31:45 crappy food.
31:46 We gave him processed food we gave him
31:49 the kid food, food kids would eat but it
31:53 was no added sugar food, everybody got
31:56 that?
31:56 And we didn't let him lose weight. Ten
31:59 days and then we brought him back and we
32:01 studied him again at the same weight
32:03 everybody got it? The liver fat went down
32:08 like crazy.
32:09 They're turning sugar into fat went down
32:13 like crazy and their VLDL went down by
32:16 49% and their insulin got better. Their
32:23 pancreas got put to rest because now the
32:26 liver was healthy. And here's just an
32:29 example of here's the change in big butt
32:33 fat. Subcutaneous fat. No change because
32:35 we didn't let them lose weight. Here's
32:37 the change in visceral or big belly fat:
32:40 down seven percent that's good and
32:42 here's the change in liver fat: 22
32:46 reduction in liver fat with no change in
32:50 calories and no change in weight just by
32:53 getting rid of the offending agent,
32:56 dietary sugar. Well it turns out we've
33:03 known about the problem of sugar for a
33:06 long time. In fact back in the 1960s
33:10 there was a battle going on between
33:12 sugar and fat. That whole battle royal we
33:15 talked about earlier, and it turns out
33:18 that we gave up on sugar and fingered
33:22 saturated fat as the bad guy and we've
33:25 altered the last 40 to 50 years of
33:28 nutrition policy and information in this
33:30 country based on that and it turns out
33:34 that it was all a fraud. All of it. And
33:38 this is an example and these were this
33:40 was done by my colleagues at UCSF
33:42 Kristin Karns, Laura Schmidt and Stan
33:44 Glans who unearthed the documents that
33:47 demonstrated that the sugar industry had
33:50 actually paid off to Harvard School of
33:53 Public Health scientists Fred Stair, the
33:56 chairman of the department of nutrition
33:58 at HS pH and Mark Hagstead, his assistant
34:02 who became the head of the USDA back in
34:05 the late 60s who exonerated sugar as the
34:10 problem and fingered saturated fat as
34:12 the bad guy and they got paid $6,500 in
34:15 the in 1965 dollars which would be
34:18 equivalent to $50,000 today. They singled
34:22 out fat and cholesterol as the dietary
34:24 cause of coronary disease and downplayed
34:26 evidence that sugar consumption was also
34:28 a risk factor. The sugar Research
34:30 Foundation set the reviews objective
34:32 contributed articles for inclusion and
34:34 received drafts. The sugar research
34:36 foundations funding and role was not
34:38 disclosed. It's been one big lie.
34:43 It was a put-up job. You're sick because
34:49 they took a nonfiction and created
34:52 fiction.
34:54 Just like the tobacco industry. No
34:57 different. So here's what happened: At
35:00 that exact same time with the advent
35:02 that processed food 1965 when these
35:04 articles were coming out. Here's the
35:06 growth of sugar, okay: In this country we
35:08 started out eating about four grams per
35:10 day from fruits and vegetables and the
35:12 occasional honey. Here's the growth of
35:13 the sugar industry like CNH and Domino
35:16 etc. you know Louisiana, Texas, Hawaii,
35:18 here's stabilization when price net
35:21 demand. Here's the rationing of World War
35:24 Two right here came back to the same
35:26 level and then you got the advent of
35:28 processed food and also the advent of
35:30 high fructose corn syrup and the advent
35:32 of the Dietary Guidelines for Americans
35:33 saying cut the saturated fat but the
35:36 flavor was in the fat. So what do they do?
35:39 They replaced it with sugar and so we
35:42 got up to 125 grams of sugar per day we
35:45 started out with 4 we ended up with 125,
35:48 a 25 fold increase in one macronutrient
35:53 had never been seen before in the
35:54 history of man and the question is what
35:58 did it do? The answer is they added more
36:02 salt - but that's not what that's not
36:04 what's driving this ok because there are
36:07 plenty of countries that have plenty of
36:08 excess salt and they don't have this
36:10 problem this here is the percent of
36:14 health care a percent of GDP in this
36:17 country spent on health care and what
36:20 you can see is until 1965 it was
36:22 relatively flat and now look at it. This
36:26 is the driver of this entire chronic
36:30 metabolic disease debacle through this
36:33 pathway and this is where why health
36:38 care can't be fixed we can't fix health
36:42 care until we fix diet we can't fix diet
36:45 until we know what's wrong. Well this is
36:49 what's wrong and no one's fixing it. So
36:53 let's do the math: The food industry
36:57 grosses in this country 1.4 trillion
37:00 dollars a year. Big number of which 657
37:06 billion is gross.
37:08 So they're making a 45% gross profit
37:11 margin on their revenue here. We got that?
37:15 45%. The next highest industry is Big
37:19 Pharma at 18% and everybody's yelling
37:23 about Big Pharma being you know the the
37:27 thieves okay. 45%. 18%. Are you kidding me?
37:33 Yet health care costs in the United
37:35 States are three point two trillion
37:37 dollars a year of which 75% is chronic
37:41 metabolic disease of which 75% of that
37:44 would be preventable if we could go back
37:46 to 1970 rates. So that's all added on if
37:51 you will so if you do 75% of 75% it's
37:55 three point two trillion you get one
37:57 point eight trillion dollars a year
37:59 going down a friggin rathole. We lose
38:05 triple what the food industry makes. That
38:09 is unsustainable and that's why
38:13 everything's going broke and that's why
38:16 Obamacare can't work and that's why
38:18 nothing can work now what do you think
38:20 we could do if we could recoup even a
38:22 fraction of that 1.8 trillion dollars a
38:26 year you think we could solve health
38:28 care you think we could solve the
38:30 federal budget oh yeah make yourself a
38:34 federal budget if we could recoup even
38:37 half of that but we can't recoup it
38:39 because our food supply is contaminated
38:42 by the industry because we like it in
38:50 fact my colleagues at UCSF and I Jim
38:53 Kahn Alex Goodell Luis Rodriguez what we
38:57 did I'm Rick Bremen actually was the
38:59 lead in this what we did was we modeled
39:01 using something called advanced Markov
39:03 modelling going 20 years into the future
39:05 based on what would happen to disease in
39:10 terms of prevalence and incidence if we
39:13 could reduce consumption of sugar by 20%
39:16 which would be like a tax or 50% which
39:20 would be like actually
39:21 hearing to USDA guidelines so in blue
39:24 and and red and you can see the fatty
39:26 liver disease the heart disease the
39:28 type-2 diabetes the OBC all getting
39:30 better and if you looked at the amount
39:33 of money that that would save it would
39:35 be on the order of about fifty billion
39:37 dollars a year just to start and that
39:40 would be just for you know for for just
39:43 like three diseases I mean you know all
39:45 the chronic disease so that's health
39:48 care that's how to fix health care now
39:51 let's look at Social Security now you
39:54 know that Social Security is a Ponzi
39:56 scheme right you know that okay the only
40:00 difference between Bernie Madoff and
40:03 Social Security is that with Bernie
40:06 Madoff you had a chance of seeing it
40:08 back till the end okay that's the
40:12 difference in fact it's a pyramid scheme
40:16 where the young healthy people pay in at
40:20 the bottom so that the old infirm people
40:23 at the top can take out everybody with
40:28 me that's how Social Security was built
40:32 and if you die before you hit 65 too bad
40:38 right
40:41 that's why the American government
40:44 didn't do anything about cigarettes for
40:47 so long you know because the actuaries
40:51 had figured out that the average the
40:53 median age of death of smokers was 64
41:00 that was in 1980 they figured that out
41:04 they paid in but they didn't take out
41:07 which was how the Social Security stayed
41:09 afloat all those years but now we have
41:13 people with chronic disease so the
41:19 bottom of the pyramid those young
41:21 healthy people they're not so healthy
41:23 and guess what they're not paying in
41:26 they're on disability and you know what
41:28 some of them are taken out like the
41:32 people who were on dialysis
41:35 okay so what happens to a pyramid if you
41:39 eat away at the base the whole pyramid
41:42 crumbles and in fact the Congressional
41:46 Budget Office has said that by the Year
41:49 2029 you can see here here's the
41:51 projected that's what's going to happen
41:53 with payable benefits
41:55 so basically no Social Security for you
41:59 now I'll be honest with you I'm gonna be
42:02 72
42:03 so at 66 in the year 2026 and the 2029
42:07 and I want my freaking Social Security
42:10 okay I worked for it I worked hard for
42:14 it
42:14 I want my friggin Medicare to our hard
42:18 worked hard for that paid in and I'm not
42:20 gonna get out and neither are you
42:21 because of this yeah in fact again let's
42:28 look at what the bank's say because they
42:31 don't have a horse in the race
42:33 so this is from Morgan Stanley another
42:36 global investment bank and this is a
42:39 report they've published two years ago
42:41 called the bittersweet actually three
42:42 years ago the bitter sweet aftertaste of
42:44 sugar where they modeled economic growth
42:47 on the y axis against the next 20 years
42:52 based on a low sugar model which we
42:55 don't have in blue against a high sugar
42:58 model which we do have in gold what you
43:01 can see is that with the high sugar
43:03 model we reach a mean economic
43:06 productivity of zero point zero percent
43:11 by the year 2035
43:13 now who is that good for is that even
43:15 good for the food industry so this is a
43:20 problem that the banks know but
43:25 Washington doesn't and neither do you
43:28 but now you do so in fact credit suisse
43:32 again another report from 2013 sugar
43:35 consumption at a crossroads and here's
43:37 what they said about this issue we
43:40 believe higher taxation on sugary food
43:43 and drinks would be the best option to
43:45 reduce sugar intake and help fund the
43:47 fast growing health care
43:48 associated with type-2 diabetes and
43:50 obesity a global investment bank is
43:52 calling for taxation now how dumb is
43:55 that but that's what we got well it
44:00 turns out San Francisco got it and
44:03 that's another reason I'm proud to live
44:06 here and I'm proud to talk to all of you
44:07 because you got it but you know who
44:11 didn't get it?
44:13 Chicago because they passed a tax and
44:17 then they rescinded it under pressure
44:19 from the beverage industry just a month
44:21 ago they didn't get it
44:24 so not everyone gets it in fact National
44:30 Geographic gets it they published this
44:32 sugar why we can't resist it in fact
44:38 they have it absolutely right
44:41 we can't resist it and the food industry
44:43 knows that because they know when they
44:44 add at you buy more.
44:46 It's the hook, it's the hook. It's the
44:50 legal addiction and that's where we're
44:54 going everybody with me that was in 2013
44:59 they could have put cocaine in the food
45:02 in fact they did until 1903 had to come
45:06 up with something else so now we have to
45:11 this thing called the opioid crisis
45:13 right Trump declares opioid crisis a
45:17 national emergency remember that just
45:19 like two months ago but requests no
45:22 funds hey how you gonna fight that with
45:25 no funds right and Jeff Sessions said
45:27 people should just say no to opioids so
45:32 my question to you is did Nancy Reagan's
45:35 just say no work that's why they're
45:39 addictive because you can know that
45:43 whatever it is that you're addicted to
45:45 is ruining your health your life your
45:48 family and you can't do a damn thing
45:52 about it because the biochemistry of the
45:55 addictive substance alters your behavior
45:58 so that you can't do anything about it
46:01 that's the definition of addiction so
46:05 just say no ain't going to work so this
46:07 is useless to say the least so the
46:12 question is who does get this who gets
46:15 this I'm going to show you a clip and
46:17 you're gonna love this
46:19 my favorite piece my favorite 20 seconds
46:23 in the history of television
46:24 you ready five six years old I was
46:39 crying sugar down my throat as fast as I
46:42 forgive you dad
46:42 sweets you know sugar on bread and
46:45 butter I'll be kind of dictated you
46:47 because it changed the way I felt so
46:51 there's Eric Clapton talking about how
46:54 he got into heroin sugar is a gateway
46:57 drug
46:59 you're laughing I'm not that's exactly
47:04 what's going on
47:06 so is food addictive is processed food
47:11 addictive well you know a lot of authors
47:14 are saying that and some of them even
47:15 have like degrees after their names okay
47:19 it's not all like junk okay the question
47:22 is you know what's the data in fact this
47:26 book came out as a text book called food
47:29 and addiction back in nineteen 2012 by
47:32 you know reputable psychiatrists and
47:34 psychologists who are friends of mine to
47:37 be honest with you so this concept I'm
47:41 gonna pose to you that we have abdicated
47:47 our responsibility based on addiction so
47:54 everybody recognize this document what
47:56 does it say
47:57 everybody knows one Clause the whole
47:59 world knows one Clause from this
48:01 document life liberty and the pursuit of
48:07 happiness so my question to you is like
48:12 Ed Koch would say how am i doing
48:14 how are we doing on each of those life
48:18 liberty and the pursuit of happiness
48:20 well let's look let's start with life so
48:25 here is the life expectancy of a whole
48:27 bunch of different countries you can see
48:30 here tonight Naseer Ethiopia Peru
48:32 they're all getting older lifes you know
48:36 I mean as they've dealt with infectious
48:38 diseases they're sort of catching up
48:40 which is that's good that's good but
48:43 here's the United States over here and
48:45 you notice we've been pretty flat and in
48:46 fact we've actually gone down recently
48:50 in fact u.s. life expectancy has now
48:54 declined for the first time since 1993
48:57 two quarters in a row first time that's
49:01 ever happened the median age of death
49:05 has gone down by about five months over
49:09 the last six months from seven seventy
49:14 eight point six down to 78 point two
49:16 years we are dying sooner now heart
49:23 disease is getting better but diabetes
49:25 has gone through the friggin roof we're
49:28 not dying a heart disease were dying the
49:30 diabetes chronic metabolic disease so
49:33 let's look at the death rates in the
49:36 United States
49:37 so here's France Germany UK Canada
49:41 Australia Sweden everyone's death rates
49:43 going down
49:44 and here's United States Hispanics going
49:49 down but look who isn't going down u.s.
49:54 White's death rates going up and who
49:59 among us whites ages 45 to 54
50:05 middle-aged u.s. whites and what are
50:08 they dying of poisonings and suicides
50:14 poisonings and suicides in middle-aged
50:17 u.s. whites that's the opioid crisis now
50:23 why is that happening
50:26 illicit drug use up marijuana
50:29 well now it's legal hallucinogens
50:31 illicit drugs cocaine said here's
50:35 illicit drug use in older adults older
50:38 adults we're not talking about teenagers
50:39 here older adults look at this 50 to 54
50:43 double here's heroin and fentanyl deaths
50:51 here's cocaine deaths
50:56 here's deaths from benzodiazepines and
51:01 this next one is the worst are you ready
51:05 this one's the worst alcohol use
51:09 disorder amongst women women so you
51:16 always think of Alcoholics as men right
51:17 but look at this from 2001 to 2012 a
51:23 virtual doubling an eighty three point
51:26 seven percent increase in alcohol abuse
51:29 disorder amongst women and which women
51:33 the older the worse
51:38 Why are older women becoming lushes?
51:41 That's the question
51:44 Do you think that's okay?
51:47 So why is that why is that their drug of
51:52 choice so not doing too well on life how
51:58 about Liberty how we doing there so this
52:01 is from Raj Chetty who was an economist
52:04 at Harvard University a very brilliant
52:05 guy and he runs a project called the
52:08 equality of opportunity project and I'm
52:10 gonna show you some data from that
52:12 project here we have the prediction of
52:18 whether or not you're going to have a
52:21 higher income or a lower income than
52:24 your parents based on where you live
52:28 where you were born actually where you
52:31 were born not where you live but where
52:32 you were born
52:33 okay and where you were born does seem
52:36 to matter quite a bit doesn't it
52:40 so let's look at New York City where I'm
52:44 from okay so here's Bergen County over
52:48 here on the west side of the Hudson
52:50River and here's the Bronx over here on
52:53the east side of the Hudson River
52:54everybody familiar George Washington
52:56Bridge connecting the two right so if
53:00you grew up we're born and grew up in
53:04the Bronx you have an 11% lower salary
53:08than your parents do if your parents
53:11were at the 25th percentile for income
53:14whereas if you grew up in Bergen you
53:16have a 14% higher salary just across the
53:22bridge now you say well that's poor
53:25people but what about the rich people?
53:28 Let's look at the 75th percentile same
53:31thing so we're trapped in our own
53:37ghettos that we make whether it has
53:42graffiti or whether it has roses we are
53:46all trapped in our own ghettos so here
53:51 are the 10 worst counties to be born in
53:55 whatever you do oh sorry the 10 best
53:58 counties to be born in I'm sorry on the
54:00 side I hear the 10 worst counties to be
54:02 born in so whatever you do what don't
54:04 move to Baltimore yeah Wow
54:10 really and finally the pursuit of
54:14 happiness
54:15 how are we doing on that so let's look
54:20 here we have ages 5 to 17 and we're
54:25 looking at Children's Hospital
54:26 admissions with a diagnosis of suicidal
54:29 ideation or self-harm over a decade here
54:33 the number of patients here the number
54:34of encounters and you can see how high
54:36that's gone and the number of encounters
54:38in the clinic have tripled in the same
54:43time period kids are depressed they want
54:48to hurt themselves and we know that the
54:52is my least favorite slide of the entire
54:54deck here we have suicides in children
54:58ages 10 to 14 okay young teenagers
55:02you'll notice the motor vehicle accident
55:05deaths are going down significantly but
55:09look what's gone up suicide
55:12so that suicides are now greater than
55:14motor vehicle accident deaths in this
55:17age group you know why the motor vehicle
55:20accident deaths have gone down because
55:23the kids aren't being carted anywhere
55:25because they're home playing video games
55:28getting depressed and killing themselves
55:34any depressant use is up nationwide in
55:39females and in males and it's up all
55:44over the world this is the World Health
55:47Organization 322 million people globally
55:50are now have a diagnosis of clinical
55:53depression and eighteen point five
55:55percent increase in prevalence over a
55:57decade and it's not because of increased
55:59awareness it's because more people are
56:03sick so my argument tonight these four
56:10crises the healthcare crisis the social
56:14security crisis the opioid crisis the
56:18depression crisis are really actually
56:20just four manifestations of one crisis
56:25and when we understand that crisis then
56:27we know how to deal with the four
56:30outcomes of that crisis and that pricess
56:33is the systemic confusion and conflation
56:37within our society of these two words
56:40pleasure and happiness now they're both
56:46positive emotions we like both of them
56:49we want both of them in our lives can
56:54anybody give me the definitions of those
56:57two words and how are they different
57:04anybody so pleasure is short-lived
57:11happiness is long-lived that's one six
57:15more to go come on come on this is San
57:18Francisco you got it you got to be able
57:19to do this huh good pleasure is visceral
57:27happiness is ethereal you know pleasure
57:30you feel in your body happiness you feel
57:32above the neck
57:33number two good job come on come on
57:37five more getting it yeah that's number
57:42four we're gonna get there okay it's
57:45like family feud
57:46survey says almost you get your clothes
57:54your clothes pleasure is taking
57:56happiness is giving pleasure is
58:00experienced alone happiness is usually
58:03experienced in social groups pleasure is
58:07achievable with substances happiness is
58:09not achievable with substances the
58:13extremes of pleasure whether it be
58:15substances or behaviors so substances
58:17like cocaine heroin nicotine alcohol
58:21sugar or behaviour shopping gambling
58:26internet social media porn in the
58:32extreme all lead to addiction every one
58:34of those has an a holic after it right
58:38shopaholic sexaholic chocoholic right
58:42whereas there's no such thing as being
58:44addicted to too much happiness and
58:48finally number seven dope pleasure is
58:52dopamine and happiness is serotonin two
58:57different bio chemicals two different
58:59neurotransmitters two different
59:00chemicals that are used in the brain to
59:03convey information two different sets of
59:05receptors two different mechanisms of
59:08action so you say like why do we care so
59:14uh
59:15they both feel good and what I would say
59:20is that understanding the difference
59:23between these two is exactly what you
59:26need to know and exactly why we're in
59:30the mess we're in today and I'll show
59:32you why before I do that let's have a
59:36little levity the MRI shows that your
59:39brain has been hijacked by dopamine
59:40pirates you are now under the full
59:42control of social media corporations
59:44gambling casinos and big pharma are you
59:46writing me a prescription no I'm buying
59:48stock in those companies and that's what
59:54we've done that's not funny
59:57I mean it is but it isn't so why do we
60:02care here's why we care dopamine is an
60:06excitatory neurotransmitter when it's
60:10released from one neuron to the next
60:12which happens in an area of the brain
60:13 called the reward center or the nucleus
60:16 accumbens it's a specific area of the
60:18 brain which we can see with fancy MRIs
60:21 and PET scanners when dopamine is
60:24 released it excites the next neuron now
60:27 that's important and the reason is
60:29 because neurons that like to be excited
60:32 that's why they have receptors in the
60:34 first place but they like to be tickled
60:35 not bludgeoned cronic over stimulation
60:40 of any neuron leads to neuronal cell
60:44 death and we know that from all the kids
60:47 who have chronic seizure disorders who
60:49 end up frying their brains which you
60:51 know I used to take care of until three
60:54 months ago when I clinically retired
60:57 okay so over stimulation of neurons is
61:01 not good so to protect themselves the
61:07 second neuron the receiving neuron has a
61:09 option B a failsafe a method of
61:13 self-defence what it does is it down
61:15 regulates the number of receptors that
61:18 it has for that transmitter specifically
61:22 to try to limit its exposure everybody
61:26 got that that's on purpose
61:28 it does that on purpose so what does it
61:30 mean in human terms what it means is you
61:32 get a hit you get a rush receptors good
61:36 now next time you need a bigger hit to
61:39 get the same rush because there are
61:40 fewer receptors and the receptors go
61:42 down and then a bigger hit a bigger hit
61:44 a bigger hit a bigger hit until finally
61:45 you get a huge hit to get nothing
61:47 that's called tolerance and then when
61:51 the neurons start to die that's called
61:53 addiction so every substance every
61:58 behavior that stimulates dopamine has as
62:03 its endpoint addiction that's why it
62:08 matters so far so good so let me prove
62:12 it here we have cocaine meth alcohol
62:17 heroin and here the dopamine receptors
62:19 in that area called the nucleus
62:20 accumbens and this is in a control brain
62:22 and here's in a addicted brain so what
62:25 you see here is the dopamine binding to
62:28 lots of receptors over here in a non
62:31 drug abuser versus dopamine only binding
62:34 to a couple of receptors because they're
62:36 way down in the drug abuser everybody
62:39 got the picture now well take a look at
62:42 what happens if you look at obesity so
62:45 here's a control brain and here's an
62:48 obese brain same thing same phenomenon
62:52 okay and that's the method the degree of
62:56 binding because there are fewer
62:57 receptors so that's what's going on with
63:00 dopamine however serotonin this other
63:05 neurotransmitter the neurotransmitter of
63:07 contentment were happiness if you will
63:09 is an inhibitory neurotransmitter it
63:14 doesn't stimulate the next neuron it
63:16 actually puts the next neuron to rest so
63:21 can you kill it if you put it to rest so
63:24 do you have to down regulate your
63:26 receptors no so serotonin does not down
63:29 regulate its own receptor but there's
63:32 one thing and so you can't overdose on
63:35 too much happiness but there's one thing
63:36 that down regulate serotonin dopamine
63:41 so the more pleasure you seek the more
63:45 unhappy you get and then throw a soup
63:52 sign of stress on top of it and I'll
63:54 show you what happens then
63:55 and things get even worse because what
63:58 stress does it inactivates the part of
64:00 your brain which controls the dopamine
64:02 and makes it worse it's called the
64:04 prefrontal cortex the part in the front
64:06 the executive function part the Jiminy
64:09 Cricket of your brain that keeps you
64:10 from doing stupid things puts it into
64:12 suspended animation and makes the
64:14 dopamine run rampant and at the same
64:17 time it makes the serotonin receptors go
64:19 down so you can derive less contentment
64:22 from whatever it is you're experiencing
64:23 and that's the path the the cycle of
64:27 addiction and depression so here's the
64:30 dopamine pathway here here's where it
64:32 starts it starts in this little nucleus
64:35 here called the ventral tegmental area
64:36 that's where the cell bodies are here's
64:38 that nucleus accumbens that reward
64:40 center and then you have this area over
64:42 here called the prefrontal cortex and
64:43 there the dopamine and the prefrontal
64:46 cortex are in a reciprocal relationship
64:48 with each other here's the contentment
64:50 pathway it starts in a different area of
64:52 the brain called the dorsal raphe here
64:54 and it innervates the entire brain
64:56 notice the dopamine didn't do that right
64:58 dopamine did not do that serotonin does
65:00 okay and then you have this stress fear
65:03 memory pathway and that prefrontal
65:06 cortex is basically inhibiting an area
65:10 of your brain called the amygdala and
65:12 the amygdala is your stress Center when
65:14 you walk down a deserted Street at 3:00
65:17 a.m. your amygdala is what you're
65:20 feeling everybody got the idea
65:23 take that anxiety about what might
65:26 happen whether there's somebody in that
65:28 you know ally or not okay that's the
65:32 amygdala okay and these two areas are in
65:35 reciprocal contact with each other you
65:36 also have the hippocampus which is your
65:38 memory center that's the part of your
65:40 brain when you put your hand down on the
65:42 stove when you were three years old okay
65:45 that's the part you remember okay that's
65:47 there yeah everybody got that so these
65:50 are in reciprocal relationship with each
65:52 other
65:53 and it turns out that BMI or weight or
65:57 obesity is in inverse association with
66:00 that prefrontal cortex so the heavier
66:03 you are the less while it's working and
66:05 in part because of this dopamine
66:07 phenomenon so here's the thesis if you
66:12 will the whole book on one slide here's
66:15 what we've done to our society
66:18 technology processed food sugar sleep
66:22 deprivation and drugs all of those drive
66:26 dopamine but dopamine lowers its own
66:30 receptor and so this is the vicious
66:33 pathway of tolerance throw some stress
66:37 on top which activates the inhibitory
66:42 mechanism and you end up with addiction
66:45 conversely all these things contribute
66:47 to metabolic syndrome all those chronic
66:49 metabolic diseases which lowers
66:51 serotonin add some stress which lowers
66:54 the receptor for that serotonin and now
66:56 you can't even conduct that feeling of
66:58 contentment and that's depression so
67:01 addiction and depression are two sides
67:03 of the same coin born out of what has
67:07 happened to our environment sure we'll
67:14 throw shopping on there - you bet so to
67:20 summarize what I've told you
67:22 addiction is excessive reward from too
67:24 much dopamine which down regulates its
67:26 own receptors it had some stress and you
67:29 get the munition of pleasure depression
67:31 is deficient contentment because of not
67:33 enough serotonin metabolic syndrome down
67:35 regulates serotonin the stress reduces
67:38 the number of receptors and therefore
67:40 you get the motion of happiness - and we
67:42 have both so the hack the question is
67:47 where it comes from who perpetrated this
67:51 pact upon us why is this nonfiction
67:56 disguised dis fiction that's the
67:59 question and I'm gonna argue that this
68:02 is industry driven and government
68:04 sanctioned that this is willful
68:07 not accidental and it's very well
68:09 orchestrated and it's a plot not a
68:13 conspiracy because the conspiracy would
68:16 require collusion between industry
68:18 actors specifically to cause our
68:23 detriment I'm not arguing that what am
68:25 arguing is that every single industry
68:28 has figured out for its own sake how to
68:31 increase its market share not talking to
68:35 any of the other companies but they're
68:36 all doing the same thing because it
68:37 works and it's engineered with a profit
68:41 motive only it's only about the money
68:44 only about the money okay here's an
68:48 example everybody familiar with this
68:51 right ten year campaign by coca-cola
68:54 open happiness ok longest-running
68:57 campaign in the history of the company
68:58 why cuz it worked any happiness in that
69:03 bottle sugar caffeine dopamine anything
69:09 us water
69:11 phosphoric acid caramel coloring huh
69:16 aspartame well fats Diet Coke yep
69:19 alright but you get the idea
69:20 nothing in there yeah right used to be
69:23 cocaine that's why it's called coca-cola
69:25 right okay how about this one a little
69:27 closer to home the road to your happy
69:31 place is paved with raisins and flakes
69:34 and pavement in other words get off your
69:41 fat ass it's your fault that's what that
69:45 says for raisin bran now raisin bran is
69:48 healthy right
69:50 No are those the raisins in raisin bran
69:57 those are the raisins in raisin bran
70:00 in fact 18 grams of sugar when you do
70:04 the math on the number of raisins and I
70:06 did this in a cup of raisin bran okay
70:09 there is nine grams of sugar in the
70:11 raisins which means that nine grams of
70:13 sugar has been added in the form of
70:16 these the the sugar coating on these to
70:19 make them
70:20 reader so that you would eat it and if
70:23 you like Raisin Bran crunch we have 29
70:28 grams of sugar for you and sugar is
70:32 second to the wheat brown sugar syrup
70:36 corn syrup honey yep now let's look at
70:43 Nestle okay they actually have a
70:46 wellness website and they have a
70:49 wellness objective they say here this is
70:52 correct this is actually truth
70:54 studies show that happiness and health
70:56 are intimately linked together the
70:57 healthier you are the happier you'll be
70:59 and vice versa that is true I won't
71:01 argue that but then comes this part
71:04 happiness comes from spending time with
71:06 loved ones fostering relationships or
71:07 learning how to cope with stress or
71:08 depression
71:09 agreed so does happiness and health
71:14 translate in other words if you're happy
71:18 are you healthy so there's a study
71:21 called the UK million women's study
71:23 where they asked this question does
71:25 happiness actually affect mortality and
71:28 the answer is no it doesn't you can be
71:33 the most crotchety old you know what and
71:36 that's not gonna make you dead okay so
71:42 don't think your uncle is gonna die
71:45 anytime soon.
71:49 What does affect mortality are the
71:54 behaviors that come from your
71:57 unhappiness. The hedonic behaviors that
72:02 you engage in in order to try to mollify
72:05 your unhappiness. That's what kills you,
72:08 not the unhappiness itself. So what does
72:12 Nestle do? Okay,
72:14 here's what they do: they want to sell
72:16 you both sugary snacks and diabetes
72:18 pills. They're getting into the pharma
72:20 business so they can create the disease
72:22 in order to treat it
72:25 and in fact they've done that all over
72:30 the world. This was in the New York Times
72:32 how big business got Brazil hooked on
72:34 junk food all about Nestle and these
72:36 promotors going around to these you
72:40 know favelas peddling Nestle products.
72:45 How about the happy meal? Not so happy,
72:49 okay. 1.5 billion toys worldwide okay and
72:54 there they are.
72:54 Oh Disney stopped selling him in 2006 to
72:56 their credit the good news is there are
72:59 fewer happy meals sold the bad news is
73:00 where the kids are ordering off the
73:02 dollar menu instead not a big win okay.
73:05 And the toy thing you know we have the
73:07 toy ban here in in San Francisco right?
73:10 You have to pay a dime for the toy. You
73:13 know there it's not free with the with
73:15 with the Happy Meal. Ok after San
73:18 Francisco instituted the toy ban three
73:21 states banned toys. Oh yeah later
73:28 how about happy hour? You know it's five
73:32 o'clock somewhere. You know where it's
73:34 five o'clock? It's five o'clock at ten
73:37 o'clock on NBC. Why do you think that
73:41 alcohol abuse is up eighty three point
73:44 seven percent in older women? Because
73:48 they've been told it's okay.
73:51 That's why, and this is particularly
73:55 pernicious because Hoda is a breast
73:58 cancer survivor
73:59 and alcohol leads to breast cancer, there
74:04 was just an article in Nature yesterday
74:07 that shows how
74:16 Red Bull...
74:22 [Music]
74:33 [Music]
74:45 So my question to you is if you're
74:48 drinking Red Bull at midnight in South
74:50 Central LA in a convenience store how
74:52 happy are you, and that's only going to
74:59 cause sleep deprivation which is only
75:00 gonna make you more unhappy.
75:02 That's called product placement people.
75:05 That's on purpose that ain't by accident.
75:11 How about this: let's add some stress. We
75:16 think that's stress right will you be
75:20 ready
75:22 men don't be ready because you know you
75:26 might your your name might be mentioned
75:28 on the network TV tonight how about more
75:33 stress how about sleep deprivation right
75:45 we go well got that and technology that
75:47 causes sleep deprivation. Let's look a
75:50 little bit more carefully at this:
75:51 Everybody see this article came out in
75:54 Axios from Sean Parker? Co-founder
75:57 Facebook "we built Facebook to exploit
76:00 you". In fact he says very specifically
76:05 exploiting a vulnerability in human
76:08 psychology "we sort need to sort of give
76:10 you a little dopamine hit every once in
76:12 a while because someone liked or
76:14 commented on a photo or a post" or
76:16 whatever it's on purpose and I'll prove
76:20 it to you. Who here uses Gmail? Gmail,
76:26 quite a few of you. Ever notice that when
76:31 you open up your mail
76:32 it takes about one-and-a-half to two
76:34 seconds for the new emails to populate?
76:38 You think Google is just slow. That's
76:43 been baked in. That's engineered in to
76:46 give you a dopamine hit, to the
76:47 anticipation to keep you coming back to
76:51 check it and check it and check it some
76:54 more. Now I'm not saying all technology
76:56 is bad like for instance who here uses
76:59 their GPS has it ever saved your life?
77:04 Saved mine, okay but to keep checking it
77:09 because it's the same every time you
77:11 check it you need variable reward it has
77:16 to be different every time and God knows
77:19 emails and likes are different every
77:21 time and that's on purpose in fact
77:24 there's a company that's actually called
77:28 dopamine dot-com
77:31 I think dopamine makes your app
77:33 addictive they'll actually program your
77:36 app that you make in order to drive
77:40 addiction and there's a four step cycle
77:43 to addiction this is from near Isles
77:45 book he's an internet entrepreneur down
77:48 in the valley called hooked how to
77:50 market habit-forming products and there
77:53 are four parts to it the first is called
77:55 the trigger or the itch if you will it's
77:57 got to be a acceptable itch in society
78:01 like for instance your email going off
78:02 in your pocket which leads to the action
78:06 which is the proverbial scratch which is
78:08 like checking your email which currently
78:11 is still socially acceptable I think it
78:14 should not be okay that should be done
78:16 behind closed doors in fact if you text
78:19 and walk in Honolulu you get a ticket
78:21 now which i think is very good we should
78:23 be doing that all over the country the
78:27 third part is variable reward so it
78:30 can't be the same every time okay so
78:32 your likes your emails you know it's got
78:35 to be something good something bad like
78:37 overstock or Groupon those are addictive
78:42 on purpose because they're supplying you
78:44 with something and they're actually
78:45 increasing stress do it now or it's
78:48 gonna go away
78:49 how about the airlines how many of you
78:53 have shopped fares on line only to find
78:57 that when you come back ten minutes
78:58 later after you've actually checked with
79:00 your family that the price went up
79:02 you think that's by accident and then
79:07 finally the only one they care about
79:09 investment
79:10 you got to plunk down a thousand bucks
79:13 for a new iPhone in fact we know this
79:19 because we've done the studies now Mark
79:23 Zuckerberg says well yes Facebook is
79:28 addictive
79:28 but it's only addictive for the people
79:31 who are depressed the people who are
79:35 depressed or the problem okay so
79:38 correlational studies show that people
79:41 who are depressed use more Facebook the
79:45 people who are not depressed which is
79:47 true that is true but that's correlation
79:51 not causation in order to causation you
79:53 have to do time lag studies well we've
79:55 done them and here they are okay in fact
79:59 if you're depressed yes
80:01 moment a moment and long-term you are
80:04 going to decrease your life satisfaction
80:06 and emotional well-being if you'd start
80:08 out depressed but even if you're not you
80:11 still do now not to the same degree this
80:14 is the chi-square value okay but it's
80:18 still highly significant everyone gets
80:21 more depressed on Facebook okay the
80:26 whole world gets more depressed on
80:28 Facebook this isn't a good thing it's a
80:31 bad thing a very bad thing and it's very
80:33 bad for our children who are the ones
80:36 who are committing suicide over it
80:39 in fact just two days ago iPhones and
80:44 children are toxic pair say to Big Apple
80:47 investors Jana Partners and California
80:51 Retirement System and Zuckerberg dilemma
80:53 when Facebook success is bad for society
80:56 indeed anybody know who this guy is
81:00 name's Tristan Harris and he's a former
81:03 ghoul exact who left the company because
81:08 Google was actually building addiction
81:12 into its products like Gmail and he knew
81:15 it
81:15 and he now runs a what he called a
81:18 nonprofit called time well-spent and he
81:23 is going to be one of the keynotes and
81:25 I'm going to be the other keynote at a
81:27 meeting in Washington two weeks from now
81:29 on tech addiction Jean Twenge
81:34 down at UC San Diego wrote a book called
81:37 ijen about this whole phenomenon and
81:40 wrote this article in the Atlantic have
81:43 smartphones destroyed a generation
81:45 indeed they have and Common Sense Media
81:48 and Kaiser are sponsoring this tech
81:51 addiction seminar workshop in DC and
81:55 Cory Booker is going to be there as well
81:57 as Katie Couric
82:00 so here we are Tec processed food sugar
82:05 sleep deprivation drugs all the things
82:07 that have happened to our society except
82:10 they haven't just happened
82:11 they've been engineered to happen
82:14 they're not by accident driving
82:19 addiction and depression consuming
82:23 healthcare killing social security and
82:26 at the root of the opioid and depression
82:30 crises in America so what can we do
82:36 about it
82:38 okay so reward is not contentment and
82:41 pleasure is not happiness reward is
82:44 dopamine contentment of serotonin
82:46 chronic excess reward interferes with
82:49 contentment stress drives reward at the
82:52 expense of contentment and business has
82:55 intentionally conflated those two terms
82:58 pleasure and happiness so that you think
83:01 they mean the same thing because that is
83:04 how they get you to buy their crap
83:09 you're unhappy you need this and you
83:13 need more of it in fact Marco Zuckerberg
83:16 when faced with this do you know he said
83:17 the cure to Facebook was more Facebook
83:23 to engage in hedonic behaviors that are
83:26 profitable to them not to you government
83:30 legislation and Supreme Court decisions
83:31 have actually made it easier to buy that
83:34 junk and engage in those behaviors and I
83:36 take those slides out otherwise we'd be
83:38 here for three hours
83:40 individuals in society have become fat
83:42 sick stupid broke addicted depressed and
83:44 most decidedly unhappy so what can we do
83:50 about it well there are some things you
83:53 yourself sitting in that chair right now
83:56 can do about it for yourself
83:58 they're called the four C's they're all
84:02 evidence-based they're all clinically
84:04 proven to work they all up your
84:07 serotonin tamp down your dopamine and
84:09 lower your cortisol or your money back
84:13 except none of them cost anything so
84:16 don't look for a refund and they're all
84:19 things your mother told you but you
84:22 forgot while you were coughing that
84:25 coca-cola while texting your BFF first
84:32 connect now what does that mean connect
84:36 that means face-to-face eye-to-eye in
84:42 your face connection that's what that
84:46 means
84:48 why why does it have to be in person
84:52 reason you have a set of neurons in the
84:55 back ear head called mirror neurons and
84:58 what those mirror neurons are doing is
84:59 they're reading the facial expressions
85:02 of the person you're talking to in
85:04 real-time and translating that into a
85:07 motion so that you end up adopting the
85:10 emotions of the person you're talking to
85:14 Paul Ekman psychologist at UC Berkeley
85:17 went to Papua New Guinea they never saw
85:19 white people never saw any people they
85:22 had the same facial expressions for the
85:25 same emotions as we did it's baked in
85:27 it's part of our DNA so your brain is
85:31 interpreting that signal in real time
85:35 and what that does is it generates a
85:38 process that ups your serotonin it has a
85:41 name is called empathy and if you can't
85:45 do that you're a psychopath
85:52 think about it
85:54 [Music]
85:56 how about religion
85:58 turns out religions kind of the best way
86:01 to explain this whole damn thing okay I
86:04 don't care if you believe in religion or
86:06 not irrelevant
86:08 there are 4,200 religions on the planet
86:11 you think any of them got it right if
86:14 any of them got it right there only be
86:15 one but every religion on the planet all
86:19 4,200 have one thing in common
86:22 community a meeting place a place where
86:25 you see other people okay
86:30 the place where you belong place where
86:32 you are see and be seen okay and that's
86:35 on purpose because that's the serotonin
86:37 it turns out what the religion is
86:41 espousing is the dopamine the vitriol
86:46 the anger the xenophobia the jealousy
86:53 that's the dopamine and how do we know
86:58 this we know this because patients with
87:01 parkinson's disease who have defects in
87:04 dopamine neurons and there are two parts
87:06 of the brain that have dopamine neurons
87:08 ones the reward center and the other
87:11 ones called the substantia nigra which
87:12 is in charge of gross motor movements
87:15 they have problems with both we started
87:19 treating these patients with l-dopa two
87:21 precursor to dopamine to make them
87:23 better back in the early 70s and they
87:25 got better from their motor disturbance
87:28 which is good and we still do it we give
87:30 them patients cinnamon today for that
87:32 reason okay but what we found out was
87:35 that a significant about 20 to 30
87:38 percent of patients became either
87:42 compulsive gamblers or religious zealots
87:47 there's a whole literature on dopamine
87:49 excess from pharmacotherapy for
87:52 Parkinson's disease so it's the zealot
87:57 tree is the dopamine the community is
88:00 the serotonin
88:02 kind of cool when you think about it
88:04 interpersonal face-to-face connection
88:07 that's what you're looking for empathy
88:09 with social media generates dopamine and
88:12 worse yet you end up in this thing
88:14 called an echo chamber you've heard
88:16 about those what do you think that is
88:18 that's just making dopamine go right out
88:20 of control and up in your stress and
88:22 studies show that Facebook use leads to
88:25 social isolation and depression sherry
88:27 Turkle at MIT a media watcher very
88:29 famous and I've subscribed to this
88:32 entirely she coined the term alone
88:35 together that's what we are today alone
88:38 together number two for second see
88:42 contribute now what does that mean means
88:45 outside of yourself contributing to your
88:48 IRA is not contribution outside of
88:53 yourself to others not for Game Boy
88:57 Scout badges is not contribution padding
89:01 your bank account is not contribution
89:04 lottery winners are not happy those who
89:06 value financial success derive less
89:09 contentment and saving generates more
89:12 contentment than spending by a lot and
89:16 spending money on yourself increases
89:18 your pleasure makes you a consumer in
89:20 fact that's what we're now called the
89:22 Consumer Price Index right we're all
89:24 consumers we stop being individuals and
89:26 now our consumers they want us to be
89:28 consumers that's what they're doing and
89:31 that's how we judge it
89:32 it's called gross domestic product GDP
89:35 it's based on consumption that's how we
89:39 measure progress
89:41 except it's not increase it and that's
89:45 what make spending money on others makes
89:47 you an individual that's called charity
89:49 and that increases happiness can you
89:52 derive happiness from your work everyone
89:54 wants to know the answer is yes you can
89:55 if you can see how your work helps
90:00 others and your boss can see it too if
90:03 that's the case you can use your work
90:06 for happiness
90:06 I used to that was my job at UCSF but
90:11 not everybody has that opportunity okay
90:13 in which case then we have
90:15 methods like altruism volunteerism
90:17 philanthropy anything that contributes
90:19 to the greater good will up your
90:21 serotonin and tamp down your dopamine
90:23 number three cope now cope means three
90:28 specific things sleep mindfulness and
90:32 exercise because all of those are
90:35 exercise for your prefrontal cortex
90:38 that's what you're doing you're
90:40 exercising your prefrontal cortex sleep
90:44 deprivation increases the amygdala and
90:46 puts the prefrontal cortex to sleep 35%
90:49 of adults get less than seven hours of
90:51 sleep per night and 23 have clinical
90:54 insomnia and some of those have
90:56 obstructive sleep apnea which makes it
90:57 even worse and caffeine reduces sleep
91:00 and increases your dopamine only to make
91:03 things worse the word of the millennium
91:08 multitasking if you're not a multitasker
91:11 you lose your job everyone has to be a
91:14 multitasker today be able to do five
91:16 things at once turns out only 2.5
91:19 percent of the population can actually
91:20 multitask the rest of us are all serial
91:23 uni-tasker 'he's switching from one
91:25 thing to another so fast and every time
91:27 that happens you get a cortisol pump
91:29 making things worse but that's what is
91:33 prized we've created that thing screens
91:39 are the antithesis of sleep in part
91:42 because of the stress and the blue light
91:43 activating the midbrain my colleague
91:46 Chris Madsen at UC Berkeley showed that
91:48 kids who get who have no charge their
91:51 cell phone in their room get 28 minutes
91:54 less sleep per night
91:55 than kids who charge their cell phone
91:57 outside their room you're going why do
92:03 you think
92:06 and smartphone apps for wellness have
92:09 not yet shown benefit. 27,000 apps for
92:13 wellness. None of them work because
92:18 they're all providing data not
92:20 information. None of them have figured
92:23 out how to actually take that data and
92:25 actually use it for something that
92:26 actually helps you. Mindfulness activates
92:29 the prefrontal cortex that's why
92:33 meditation works because you are
92:35 focusing on one thing
92:37 improves metabolic health alleviates
92:40 depression and it turns out exercises as
92:42 good as SSRIs at alleviating depression
92:44 problem is getting somebody who's
92:46 depressed exercise that's the tough part
92:48 and finally cook there's our next
92:52 president on the cover
92:56 [Applause]
92:58 Why cook? Because there are three items
93:01 in food that actually matter to up your
93:03 serotonin: First one tryptophan, the
93:06 precursor to serotonin the rarest amino
93:08 acid in the diet. So what has it? Fish,
93:11 eggs, poultry. Not things commonly found
93:16 in processed food, okay? So you're not
93:18 getting very much if you're eating
93:19 processed food process was low in
93:21 tryptophan low in omega-3 fatty acids
93:24 which are anti-inflammatory it's been
93:26 shown that the serotonin Bouton's on the
93:29 in in the brain have an inflammatory
93:31 haze around them in omega-3 deficient
93:34 animals and it goes away when you give
93:36 them the omega-3 so you improve
93:38 neurotransmission and then finally high
93:42 sugar sugar ups your dopamine like crazy
93:45 downs your serotonin so a low tryptophan
93:49 low omega-3 high sugar diet that's
93:51 called processed food a high tryptophane
93:54 high omega-3 low sugar diet that's
93:57 called real food problem is one third of
94:00 Americans don't know how to cook and if
94:03 you don't know how to cook your hostage
94:04 to the food industry for the rest of
94:05 your life and that's where we are okay
94:08 real food matters and the real food
94:13 movement is in high gear and companies
94:15 who don't change will be left in the
94:16 dust unless they are bought up and
94:19 the startups and we will see what Amazon
94:22 does with Whole Foods Campbell Soup
94:27 broke with the grocery Manufacturers
94:29 Association of America on this issue of
94:32 real food cooking is all things at once
94:37 it's connecting over a meal with your
94:40 friends or family not your extended
94:43 family that's called Thanksgiving forget
94:45 that contributing coping because it's
94:49 mindful because you actually have to pay
94:51 attention and cooking sitting down
94:55 cooking a meal and sharing it with your
94:58 family is the single best thing you can
94:59 do for yourselves and no one's doing it
95:03 so what can we do
95:05 societally or professionally? So five
95:08 modest proposals for you to ponder first
95:12 at UCSF we've gotten rid of sodas the
95:17 healthy beverage initiative at Swedish
95:20 Hospital in Seattle they've gotten rid
95:21 of juice and just today the NHS in
95:27 Britain has banned sodas and sweet
95:31 beverages from all hospitals in all of
95:33 the UK today January 9th 2018 Wow holy
95:45 crap
95:47 and you know why they did that because
95:50 we did it here at UCSF they did it
95:55 proposal number two let's call type 2
96:00 diabetes' what it really is
96:02 you know diabetes is an Egyptian Greek
96:05 word means siphon do you know that
96:08 because you're peeing your brains out
96:10 the whole day you know like let's call
96:13 it what it is
96:14 you got processed food disease I think
96:18 that might make a difference in how
96:20 people dealt with it because that's what
96:23 it is
96:24 proposal number three let's roll back
96:27 the subsidies for all the things that
96:29 are killing us these are all commodity
96:32 crops it's a legacy from 1933 the
96:35 original Farm Bill when we had the Dust
96:37 Bowl in the Depression when we needed
96:40 storable food. Today we don't need
96:43 storable food, it's actually killing us.
96:45 So people say well that'll make prices
96:48 go like up like crazy not true so this
96:51 is from UC Berkeley the Gini Foundation
96:54 farm subsidies and obesity in the United
96:56 States and they actually modeled what
96:58 food would look like if we got rid of
97:00 all food subsidies and it turns out the
97:03 only things that would go up corn and
97:05 sugar exactly what we want to go up
97:14 [Music]
97:16 indeed indeed proposal number four a
97:22 trust mark so if you see this in a
97:26 restaurant you know that whatever
97:27 they're serving can't kill you
97:30 okay and then competitors will say wait
97:32 we're losing business to people who are
97:35 serving real food maybe we need to serve
97:36 real food this is our nonprofit that I
97:39 mentioned at the beginning eat real and
97:41 finally oh and by the way UCSF cafeteria
97:46 is real certified so is Boulder Valley
97:50 School District we're trying to do that
97:54 here and finally number five let's get
97:58 sugar off the generally recognized as
98:00 safe list because it's not safe it's
98:03 just like alcohol
98:05 the reason kids are getting type 2
98:07 diabetes and fatty liver disease today
98:09 is because those are the diseases of
98:12 alcohol but kids don't drink alcohol and
98:17 the reason is because sugar and alcohol
98:19 are metabolized exactly the same way in
98:21 the liver causing that fatty liver
98:23 disease I showed you and driving all the
98:26 chronic metabolic diseases we know of
98:28 today so in summary we have solved the
98:35 healthcare crisis we have solved the
98:37 social security crisis we have solved
98:40 the opioid crisis we have solved the
98:43 depression crisis and I hope I've made
98:47 you happy you came
98:50 [Applause]