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