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Transcript

  • 02:00 About Dr. David Ludwig
  • 05:42 About Always Hungry
  • 09:14 Why Willpower Doesn’t Work
  • 17:47 The Always Hungry Solution
  • 19:03 The Research Behind the Always Hungry Solution
  • 28:51 Intermittent Fasting
  • 36:43 Top Tips for Kicking Food Cravings
  • 39:35 A Quick Summary of Always Hungry
  • 41:33 The Most Pressing Health Issue in the World Today: Obesity
  • 44:18 Obesity as an International Crisis
  • 47:02 Where to find Dr. David Ludwig

Wendy Myers: Hello, my name is Wendy Myers. Welcome to the Live to 110 Podcast. Today, we have a very special guest, Dr. David Ludwig. He is the author of Always Hungry?. It’s a fantastic new book about how to change your metabolism and that’s what he’s going to be talking about today on the show. He’s so knowledgeable. He’s a Harvard researcher. He’s such a great guest and I’m excited to have him on the show.

Please keep in mind that this podcast is not intended to diagnose or treat any disease or health condition and it is not a substitute for professional medical advice. Please consult your healthcare practitioner or your physician before engaging in any treatment we suggest today on the show.

Wendy Myers: And if you haven’t already, please go take a peek at my new supplement, Liver Rehab. It’s available on Amazon. I created this formula because I couldn’t find a formula on the market that I really, really liked and I wasn’t super happy with the ingredients in some of the formulas out there.

So I created this supplement to help your liver optimally detox because you guys know that I’m really big on detox and you can’t detox your body unless your liver is functioning optimally. So it’s very, very important to tend to liver health. Our livers are so overloaded today with toxins, with bad diets full of sugar and carbohydrates, which we’re talking about today on the show. And it’s very, very important to give your liver support so that you can be healthy.

That’s why I created this supplement. Go check it out at Amazon. Search for Bio Rehab. That’s the brand, Liver Rehab.

02:00 about Dr. David Ludwig

Wendy Myers: Today on the show, Dr. David Ludwig is going to be addressing the underlying drivers of weight gain, which are basically fat cells stuck in calorie storage overdrive. We are going to be in a battle between mind and metabolism that we just can’t win.

Cutting back on calories won’t do it. That doesn’t change biology. To change biology, you have to change the kinds of foods that you’re eating. And fortunately, researchers like Dr. David Ludwig are discovering what’s really behind these cravings and how to turn them off. Today, he joins the show to discuss what the latest studies reveal about ridding food addiction and hacking hunger.

Dr. David Ludwig, he’s an MD and PhD and he’s a practicing pediatrician and researcher at Boston’s Children’s Hospital. He holds the rank of Professor of Pediatrics at Harvard Medical School and Professor of Nutrition at Harvard School of Public Health. Dr. Ludwig is Founding Director of the Optimal Weight for Life, the OWL Program at Children’s Hospital, one of the country’s oldest and largest multidisciplinary clinics for the care of overweight children. David comes on the Live To 110 Podcast to discuss food addiction, willpower and how to hack hunger.

Dr. Ludwig, thank you so much for coming on the show.

David Ludwig: It’s great to be with you.

Wendy Myers: Why don’t you tell the listeners a little bit about yourself and your background?

David Ludwig: Sure. I’m a practicing physician and a researcher based in Boston at Harvard Medical School, Harvard School of Public Health and Boston’s Children’s Hospital. And I’ve been looking at ways to think about food independent of calories, beyond the calorie in, calorie out model of weight control, which I hope we can get into, that has not worked very well, but instead, to see food as so much more.

Every time we eat, we alter our hormones, metabolism, even the expression of our genes in ways that can take us toward a healthy weight or weight gain, toward freedom from chronic disease or a likelihood of heart disease or diabetes. And this is all relating to how the metabolic effects in food far beyond the calorie context.

Wendy Myers: So how did you become interested in nutrition?

David Ludwig: I went to medical school and like so many medical students, I got very little training in nutrition. We tend to focus a lot on drugs and surgery although ironically diet causes most cases of chronic disease. And we don’t have so much obesity, heart disease or diabetes because we have a genetic requirement for drugs that have yet to be discovered.

So I got interested in this. And since I had very little training in nutrition, I didn’t start thinking about diet in the conventional way. I started thinking about it as an endocrinologist, which is my clinical focus in my area of research, hormones, how food affects hormones. And that leads to some very surprising and alternative ways of thinking about weight control.

Wendy Myers: Yeah, I love it that you’re a physician that’s thinking out of the box that’s thinking more about nutrition because that’s what I think I complain about a lot in the podcast, these physicians that are not tending to nutrition and supplementation because these are one of the main underlying root causes of disease. So I applaud you for that and that’s why I wanted to have you on the podcast.

05:42 about Always Hungry

Wendy Myers: So you wrote a book, Always Hungry? What is the basic message of your book, your message that you’re trying to get out to the masses?

David Ludwig: The premise is simple, but provocative although I will argue that it’s based on a century of solid research and research we’ve done in my group for the last 20 years. The premise is that overeating doesn’t make you fat, at least not over the long term. The process of getting fat makes you overeat. Let me explain that.

Something has triggered our fat cells to hoard too many calories. So they feast, but the rest of the body actually starves. We think of obesity as the state of excess, overabundance, but if those fat cells are growing too fast and hoarding too many calories, to the body, it’s a state of starvation.

So the brain does what it’s supposed to do. It makes us hungry. It doesn’t see the extra calories in the fat cells. It sees that the bloodstream doesn’t have a steady supply. So it makes us hungry. That’s one part of the brain that lights up. Another part of the brain makes us crave. It’s very difficult to not eat when those two things are happening.

And it makes it even harder by slowing down metabolism, which is a very sensible thing to do if you’re really starving. But in the case of fat cells on calorie storage overdrive, they continue to take the lion’s share of what we eat and it leads to progressive weight gain. It doesn’t solve the problem.

Now, if you just cut back calories like we’re told to do, eat less, you can slow weight gain down or even lose weight temporarily, but your body is going to fight back even harder because it just makes that basic problem worse, not enough calories in the bloodstream.

Let me give you an example, the analogy to the condition edema. Many of your viewers will know what edema is. That’s where fluid leaks out of the blood vessels and collects body tissues. The legs might swell greatly.

Someone with edema has too much fluid in the body, maybe 20 lbs extra or more. But they’re oftentimes unquenchably thirsty. The brain doesn’t see that there’s too much water in the body. It sees that it’s not staying in the bloodstream where it’s needed. And so if you tell people just don’t drink, that’s very hard to follow and it still doesn’t solve the problem. In the same way telling people with obesity just don’t eat as much is very difficult to do and it’s still not addressing the problem.

If you treat edema so that the blood vessels aren’t so leaky and the fluid stays in the bloodstream, then the body sucks up the extra water, releases it and your thirst is really controlled. And that’s the same in obesity. You treat the fat cells on calorie storage overdrive. They open up, they stop hoarding so much, they calm down, they open up, release those calories back into the body. You feel a flood of energy, cravings vanish, metabolism speeds up and you start to lose weight with your body’s cooperation, not with your body kicking and screaming.

Wendy Myers: Yeah, because we know that willpower doesn’t work. There are definitely some people that can really override their biology’s messages and not eat or have a very strict caloric diet, but most of us are not able to do that.

09:14 Why Willpower Doesn’t Work

Wendy Myers: Can you talk about why willpower doesn’t work?

David Ludwig: We know the body weight. This is well known in the laboratory. Body weight is much more about biology than willpower over the long term. Yes, we can either force-feed ourselves.

So let’s take some classic studies, for example, the force-feeding studies that have been done for decades. You can take either an experimental animal or humans. And you lock them up. Of course, they’re volunteers, so they’re doing this with an agreement corporation. You have them consume hundreds or a thousand of calories too much a day and they will gain weight.

But what happens? First, they lose all interest in food. Their metabolism speeds up in an attempt to get rid of those extra calories and they actually feel miserable. They’re as unhappy as participants in starvation studies are. Once the force-feeding protocol ends, weight comes right back down to where it started.

So we know that there seems to be biological control systems that determine what your body weight should be. If you’re lean, it tends to stay lean. If you’re heavy, it tends to stay heavy although something is causing that set point to keep creeping up year after year throughout the population.

So it’s not just genes. Something is going on in the environment. We argue that it’s mainly aspects of our diet that raise insulin levels too much. Our lifestyle can affect this too. Insulin is the ultimate fat cell fertilizer.

When someone with a child with type 1 diabetes, juvenile diabetes, first comes in before they have been diagnosed, they’ve invariably lost weight. There’s not enough insulin. They could be eating 5000 to 10,000 calories a day and they’re still losing weight. Give them enough insulin and their weight returns to where it’s supposed to be or where it was. And then give them too much insulin, which sometimes happens and they invariably gain weight.

You can’t store calories without insulin. Now for those of us who don’t have diabetes, your insulin levels don’t change based on injections. They change based on what you eat.

The foods that make the most insulin, calorie by calorie, are the processed carbs, white bread, white rice, potato product, fat-free cookies, candy, cereals and of course sugary drinks and the like. These raise in some levels and program their fat cells into calorie storage overdrive. So they feast, the rest of us starves.

We have to get at that source of the problem. Otherwise, just cutting back on calories, as you said, creates this battle between mind and metabolism that most of us will lose. Even if you can’t force yourself not to eat, you’re not necessarily getting into the best biological state.

For example, when you give animals too much insulin, you just inject them with insulin, they get hungry, overeat, gain weight, get too fat. You can put them on a diet. Keep giving them insulin and put them on a diet and you can prevent them from gaining weight. They start cannibalizing their lean tissue. So they all develop too much fat and at the expense of their lean tissue even if you keep them from gaining too much weight.

Unfortunately, there are a lot of people in this state. It’s the state of “lean outside, fat inside.” I think there’s a name for this. I’m blanking on it.

Wendy Myers: A skinny fat person?

David Ludwig: Yeah, “fat inside, lean outside” or “thin outside, fat inside.”

Wendy Myers: Yeah.

David Ludwig: So that means that we’ve got this metabolic problems inside, which may or may not reveal themselves in our body weight, but that still very much increase risk for chronic disease, cause us to feel not great variable energy and cravings even if it doesn’t manifest in weight gain.

Wendy Myers: And the catch 22 is many people that are overweight that have metabolic syndrome eventually develop diabetes and then they have to inject insulin and they end up gaining weight as a result of it worsening their condition. I saw this happen with my father and I see it with my aunts and uncles that are on insulin. They keep gaining and gaining and gaining more weight.

David Ludwig: So you’re talking about type 2 diabetes, which is a different kind than the type 1 juvenile where you just don’t make it up. In type 2, the basic problem is that the body starts getting resistant to insulin. And so the cells that make insulin in the pancreas can’t keep up with that increased demand.

And then we try to deal with the situation in the rising blood sugar by giving even more insulin. Typically insulin levels are oftentimes already very high. So I want to say that that is sometimes maybe necessary if blood sugar is very high and that can be critical.

I’m not asking people to give up their insulin, but over the long term, it’s not a good strategy. It’s adding fuel to the fire. The fire is that we have already high insulin levels. Our fat cells are hoarding too many calories. We’re developing chronic inflammation, which is a condition closely linked to insulin resistance.

We just increase insulin levels to try to deal with that, but yes, you can bring blood sugar down at the expense of further weight gain. And so a much better approach is measures that reverse this physiology. And we know that can be done sometimes with complete resolution of type 2 diabetes if they’re instituted within the first few years and you can get improvements at any point.

Bariatric surgery can cause total remission and gastric bypass, total remission in type 2 diabetes if it hasn’t been around for a very long time. And there’s no reason that diet can’t do the same thing or the calorie restriction doesn’t work.

But there’s a lot of promise with lower carbohydrate diets. What I’m recommending in my book, Always Hungry? is not a very low carbohydrate diet. We start by getting rid of the processed carbs and we do that by increasing fat. It’s very lush, delicious.

Fat is very tasty. We used to really love eating it. The French love eating fat. They eat a lot of it and they have lower heart disease rates than we do, so nuts, butters, full fat dairy, avocado, real dark chocolate, savory proteins and natural carbohydrates, the fruits, vegetables and legumes.

In phase one, which is two weeks of the program, we get rid of all grains, potatoes and added sugar. So that really helps jumpstart a metabolic change.

Phase two, your weight comes down to this new set point and you get to add back in phase two whole kernel grains, old world kind of grain products, steel cut oats, quinoa, buckwheat, wheat berries.

And then in phase three, you can add some of the more processed carbohydrates, more sugar based on your body’s ability to handle it. Again because this approach with and not against your body, you eat until satisfied, snack when hungry and forget calorie content.

17:47 the Always Hungry Solution

Wendy Myers: So this is the program that you lay out in your book. What is the program called?

David Ludwig: We call it the Always Hungry Solution and the book is Always Hungry? We can’t call it the Always Hungry Diet because this is actually the opposite.

It’s a way to lose weight without having to battle hunger and fatigue by going to the source of the problem, fat cells that are fighting you. They are feasting and we are starving. We got to retrain our fat cells and this book is about how to do that. The key is right diet to lower insulin, to calm chronic inflammation. We also bring in some other supports that help fat cells to calm down and the three-hour quality sleep, stress reduction, stress relief practices and enjoyable physical activities.

The physical activities aren’t so much to burn off calories. You can spend 20 minutes, 20 grueling minutes on a treadmill and replace those calories in less than a minute with a handful of raisins. The benefits of physical activity of marathon levels are to improve insulin sensitivity and begin to improve chronic inflammation.

19:03 The Research behind the Always Hungry Solution

Wendy Myers: So why don’t you talk a little bit about the research that you’re doing that helped you to develop this diet or develop this program rather?

David Ludwig: This is in an area of research my book has been following. My research partner is a woman named Dr. Cara Ebbeling. She and I have been doing this work together for years. We have been looking at again how food, independent of its calorie content, alters our hormones, alters our metabolism and alters the expression of our genes.

I can tell you about a couple of studies. In one case, we gave young men who were overweight, were obese two different milkshakes. Actually, the milkshakes have the same protein, fat, carbohydrate. They were designed to have the same sweetness.

One had fast acting carbohydrate, carbohydrate that’s going to digest very quickly. It is called high glycemic index. The other had slow digested carbohydrate. It doesn’t raise blood sugar, insulin very much. We did this in a double blind fashion. That’s rare in nutrition research. So neither the participants nor the investigator who is giving the milkshakes knew which was which.

When we analyzed the data, we found that as expected, after the fast acting milkshake, blood sugar initially surged and insulin went way up. But a couple of hours later, blood sugar crashed. That was in four hours and at that time, people reported feeling hungrier even though they go the same calories. They felt hunger.

And then we did imaging of the brain with a very advanced technique called Functional Magnetic Resonance Imaging, FMRI. And we saw that one area lit up like a laser after the fast acting milkshake compared to the other one. In fact, it happened in every single subject. We’ve rarely seen such a strong consistent effect in a research where everybody does the same thing.

And that area has the technical name of the nucleus accumbens. So the nucleus accumbens is the center of the dopamine pleasure and reward system, considered ground zero for the classic addictions of cocaine, heroin, alcohol and the like, which raises a provocative idea that yes, we need food to live as opposed to drugs or alcohol, but that these highly processed carbohydrates due to their effects on our biochemistry are hijacking the brain reward systems.

And that is making it very, very difficult for people to control their cravings. So again, if you’re hungry a lot, that’s bad enough. If your addiction centers light up, it’s game over.

We also did another study to look at the other. So that’s our ability to say no to food intake. Another study looked at energy expenditure. We gave 21 young adults, again with high body weight, first the low calorie diet to bring the weight down and of course calorie restriction works in the short term. We bring the weight down by 12%.

And then we put them for a month at a time on one of three diets. These are low fat, medium to high fat, 40%. So low fat is 20%. Medium was 40%, which was already rather high. It’s a typical Mediterranean diet. Or a very high fat diet like Atkins, 60% fat. So we put them on these diets for a month at a time in random order.

We found that on the low fat diet, metabolic rate, their calorie burn plummeted, 400 calories a day. It’s slower. Their metabolism is running. In the low carb diet, there was no fall off in calorie burn at all from before they lost weight, so they have lost the same 12% or so of their body weight, but their brain didn’t even feel like it had lost weight. It wasn’t trying to go into starvation mode.

The Mediterranean diet, the 40% fat was in the middle. So there’s difference between the low fat and the high fat diet in their calorie burn. It was like an hour of moderately vigorous physical activity without lifting a finger. That difference, if you could put it to use for you, it’s pretty much the whole obesity epidemic.

23:54 Paying Attention to Your Body

Wendy Myers: Yeah. And do you think there are some people – I mean you had the people on the high fat diet that were losing more weight, et cetera. Do you think there are some people that don’t do well on a high fat diet? Say they have genetic reasons or other metabolic issues where they wouldn’t do well on a high fat diet.

David Ludwig: Yes. So just to clarify, in that study I just told you about, we locked everybody’s body weight the same. So they all lost the same amount of weight and we could see the differences in their calorie burn independent of weight change beyond that.

But I think yes. In our book, the Always Hungry Solution doesn’t ask everybody – first of all, it’s not an Atkins type, very low carbohydrate diet. I don’t think that for most people, we need to go to that extreme although some people, for example with severe metabolic problems like type 2, may reverse the quickest with a very low carbohydrate or even a ketogenic diet. But I think for most people, that level of restriction is necessary. It allows for a much more flexible approach to eating.

But I do believe that people differ. So we start everybody on a 50% fat diet that has 25% carbohydrate. That’s pretty high, but you’re still eating fruits and vegetables. You’re not getting rid of those things. And it’s just two weeks just to jump start metabolism. And then we start lowering the fat turning toward 40%. So, most people will wind up 40% fat, 40% carb, 20% protein. That’s some very balanced diet. It’s how we ate before the low fat craze started 40 years ago.

But we have tracking tools, symptom checkers that let you see your tipping point. There are some people, and we believe we can identify them to some degree in advanced, the high insulin secretors were really going to do best with keeping those processed carbs pretty low and staying on the high fat side. Other people who are low insulin secretors have much more flexibility and may actually do fine with much more carbohydrate.

But again, one size isn’t going to fit all here. And by paying attention to your body, following your symptoms and food cravings, hunger, energy level, wellbeing, you can find your own tipping point. You reach it and then you pull back a little bit realizing that the rewards of feeling in control all over your cravings and not having to fight your body are so much greater than the fleeting pleasure of highly processed carbohydrates.

Wendy Myers: Yeah, I love that you said that, that people need to pay attention to their bodies and find what works for them because everyone is so different. And ultimately, you want to use a book as a guide and I think your book is so well-researched and well-written. It’s a fantastic guide. But ultimately people do have to play around with things, play around with their percentage of their macronutrients to find out what works for them.

David Ludwig: We walk people by the hand there. I think the ultimate example of that is a diet book author or anybody who’s prescribing a calorie restriction, saying you should 500 calories less or a thousand. That’s forcing the body to lose weight. It dictates something external to the body.

We believe that if you create the right internal conditions, your body determines what rate of weight loss is right for you. For some people, we did a national pilot, 250 people from around the country. Some people lost weight and again they’re eating as much as they want, they’re snacking when hungry, not calories [inaudible 00:28:01]. Some people still lost weight at a rate of 2 lbs a week or more. Others were losing weight at just maybe a half pound. But without hunger and feeling great, the results are progressive and sustainable.

In contrast to calorie restriction, popular diet that promises 30 lbs in 30 days, then what happens? You’re starving and struggling for the rest of the year to keep the weight off. So we have outsourced control of our body to others. If we feed our body right, it will figure out. It will automatically move itself toward optimal health. That’s how it’s been designed.

28:51 Intermittent Fasting

Wendy Myers: What is your opinion of intermittent fasting? It’s very, very popular today and there are even books that say, “Do 500 calories one time a week or two days a week” or “Don’t eat for half a day.” What do you think of intermittent fasting?

David Ludwig: I think that there are some interesting potential benefits from fasting. The argument is that the humans evolved during food unpredictability although frankly many societies and even hunter-gatherers have plenty of food most of the time. It’s not like they were eating hand to mouth. Humans were really successful hunter-gatherers.

But yes, there were of course times without food and we would have gone into a fasting physiology, made ketones and that could be very good for the brain and body.

I think the fundamental problem right now is we are actually in a starvation state. The body doesn’t have enough calories in the right place in the bloodstream and that’s why we’re hungry. So then you tell people like that, “Well, just stop eating.” That’s tough.

Now, if you change the quality of what you’re eating, then it becomes much easier to fast. But I think that’s an advanced degree. We’ve got to start out in grade school and high school for most people by putting an end to the starvation that’s happening inside their bodies.

And the best way to do that is we tell people. Don’t starve yourself. Eat as much as you want. Don’t starve yourself. Listen to your body. Phase one is three meals and two snacks a day of lush, high, rich, satisfying savory fruits. And eat until you’re satisfied and you still start losing weight because it turns off the starvation.

Now, once people feel like they have mastered that and the diet quality is really high, then you can play with intermittent fasting on top of that. But again, when you start off with intermittent fasting, you may make a bad situation worse.

Wendy Myers: Yeah, I absolutely agree with you. You can’t go from the standard American diet, eating carb-rich diet to fasting because I think a lot of people get the blood sugar drop and then they overcompensate with eating everything in sight. They can lose their willpower. So I agree with you. You have to start eating a healthier diet, higher fat diet and then maybe play around with that. And see if it works for you. I don’t think it works for everyone.

31:41 Different Factors for Poor Insulin Release

Wendy Myers: So you said there are some people that don’t release insulin so well from the pancreas. And the others release it very readily. Can you account for some of the differences and why that’s the case starting with their genetic reasons? But do you account for any toxicity levels that prevent insulin release from the pancreas or any mineral or nutrient deficiencies that inhibit that?

David Ludwig: Well, there are undoubtedly many. Micronutrient and other nutrient phytochemical deficiencies can affect insulin dynamics, glucose control in many ways, the beta cells that make insulin and the target cells that affect insulin resistance.

This is a whole foods approach. I think some supplementation is prudent, but not as an alternative to whole foods approach, which is going to have many more things than any supplement can ever. That’s the foundation there. I think that 90% of it for most people.

Although I think that if you’re in the Northern Latitude and not getting much sunlight, some vitamin D supplementation is helpful. If you’re not eating much fish, long chain omega-3 supplement is good. If you’re not eating fermented foods, then you take a probiotic. Those are the three top of the line.

And then there are others who argue that with the soils that we’re growing our foods in are depleted and aren’t containing as many. So there may be a role for additional supplements beyond that, but I think that’s secondary and the primary focus of the book is the foundations of good nutrition. A whole foods diet is going to provide so much more in so many more combinations than can ever be distilled into a pill.

33:48 Dr. Ludwig on Past Human Diets

Wendy Myers: Yeah, absolutely, absolutely. So how many meals do you think people should eat per day? You said in your book that you start people out with three meals per day and two snacks. But evolutionary-wise, a lot of the population ate one or two meals per day. Do you have any thoughts on eating the way that man used to eat for the millennia? Do you have any comments on that?

David Ludwig: Man and woman ate so many different ways based on culture, location, food availability, season, if the berries were in season. If you were an Inuet in the far north, most of the year, you would have been eating just fat and protein, fish, caribou, maybe a whale or whatever. And then the berries would come in, in August and September and you would gorge on that.

I don’t know that we can come up with an optimal meal pattern considering our Paleolithic ancestors. But I think it’s important to start by addressing the fundamental problem in weight gain and obesity, which is that our body is actually starving.

Wendy Myers: Yeah.

David Ludwig: The fat cells, but there aren’t enough calories in circulation for the rest of the body. So we’ve got to eat the right foods and start eating regularly. That lets hormones calm down and tells the brain, “Wait a second, there is enough. You don’t have to protect me this way holding on to every calorie. You can relax. You can let those calories start to flow out of the body because there is abundance.”

And that I think we recommend starting by three meals and two snacks a day. Let your body decide. If you’re not hungry, if you really don’t want a snack, your body is very quickly trying to get rid of calories, you’ll just not be interested in so much food. So you just have a very light meal.

We want people not to skip meals for the first two weeks. After that, then you can begin to individualize. There are days where I do like to not eat three meals, but I don’t have hunger when I do it because my metabolism is in a much better state than it was 20 years ago when I was eating a standard conventional low fat, high carbohydrate diet.

Wendy Myers: Yeah, I found that as well when I began eating much, much healthier. Overtime, I needed less food. So today, I only need about two meals per day, maybe a snack. But I’m surprised at how little food I need. I do a lot of supplementation as well, so I get lots of nutrients.

36:43 Top Tips for Kicking Food Cravings

Wendy Myers: So what are your top tips for kicking food cravings?

David Ludwig: I think just one really, which is to feed your fat cells well. Once we reprogram fat cells to calm down and release their calories back into the body, cravings vanish.

In our national pilot, people reported and the stories are through the book. They’re authentic. We didn’t make anything up. This is what they said. They reported that cravings tend to vanish before the first [inaudible 00:37:16]. That was a pretty consistent experience among our pilot participants. I think these cravings take care of themselves and it automatically guides us to eating properly.

Let’s do a little though experiment. Let’s think of a few different things that one could binge on, one might crave or binge on. Highly processed carbohydrates, so bread, to get 400 calories, maybe that would be five slices for yourself. So five slices of bread.

Another thing you could do is eat three big bowls of berries, big, big bowls of berries. That’s full-acting carbohydrate. A fat you could binge on would be butter. A lot of people think butter is very tasty. So I have a stick of butter of five packages of beef jerky without the sugar. Many people think berries are very tasty.

If you said, “What’s tastier, bread or butter?” people would mostly say butter. But what’s going to happen if you try to binge on just butter? The first bite might taste okay. The second bite, “This is getting a little weird.” Third bite, you’re getting sick to your stomach. Why is that? That’s because you can’t binge unless you got processed carbs that raise your insulin levels.

You binge on the bread, it doesn’t taste so good. But your [inaudible 00:38:51] surges and crashes and you want more a few rounds later. You binge on the butter if you could yourself to eat 400 calories of butter. You are not going to be binging on anything for beef jerky and same for the berries.

We’re binging not because we have poor willpower and we’re not doing it because the food is so tasty. Things that people binge on are not inherently so tasty. We’re doing it because our body is driving us to do it. And just to try to control that with willpower is a losing proposition. Control it biologically, that’s fighting fire with fire and then you’re in control.

39:35 A Quick Summary of Always Hungry

Wendy Myers: Yeah. So why don’t you talk about what your main message is in your book, just a summation of the main message?

David Ludwig: Sure. Maybe I’ll just show the cover. There it is, just out last week, Always Hungry?

Again, it’s a meal plan, three-phase meal plan to lower insulin, calm chronic inflammation, so high fat diet, nuts, nut butters, full fat dairy, real chocolate, proteins either vegetarian of meat options – we give both – natural carbohydrates. Then we slowly add back more processed carbohydrates.

We combine that with attention to quality sleep. We walk people through creation of a sleep sanctuary in their bedroom so that we can deal with the overstimulation that’s causing us to stay on all the time. That also takes a toll on our fat cells.

Quality sleep, stress relief and then enjoyable physical activities, one of them is the Passeggiata, which is an Italian habit of going for a walk after dinner where you not try to burn off calories, but you socialize. Go out, you meet people in the community, tune up your metabolism and feel good. That’s really all we’re talking about.

Yes, it’s perfectly fine to do more physical vigorous workouts. But just daily practice, quality sleep, stress relief, enjoyable physical activities, right approach to diet, you reprogram your fat cells to work with you.

41:33 The Most Pressing Health Issue in the World Today: Obesity

Wendy Myers: Well, I have a question I like to ask to all of my guests. What do you think is the most pressing health issue in the world today?

David Ludwig: In broad terms, it’s obviously diet-related diseases in the developed world. The developing world still has a lot of undernutrition, starvation, we can’t forget that, infectious illness.

But in the developed world and increasingly in developing countries, obesity, diseases of so called “overnutrition,” which I’m arguing as actually starvation inside the body. Diet-related diseases, they have surpassed smoking as the number one cause of preventable chronic disease.

We predicted in 2005 in the New England Journal of Medicine that life expectancy will begin to decline in this country in the next couple of few decades. Unless we do something about obesity beginning with children, then we’re already starting to see a stalling of life expectancy, especially with the highest obesity prevalence in the country.

This is in the epilogue of the book. I argue this is a matter of national security. If we’re spending more and more money trying to manage chronic diseases, medicines to lower blood sugar, to lower blood pressure, to lower blood cholesterol, to keep our blood from clotting excessively, to manage depression, impotence, all of these other consequences of unhealthful diet, if all the money is going there, there’s no money left for the nice things in life, for investing in our social infrastructure, for education, for these things. And that’s fueling political debate in Washington and it’s probably one reason driving such fierce polarization of the parties.

If we could address diet-related disease, we have so much extra money, the Democrats could have social spending and Republicans could have a balanced budget and we’d have a chance to actually detoxify the political environment in Washington.

Wendy Myers: Yeah, I wonder the same thing. If our future medical crisis and if the amount of money we’re going to have to spend on medical care is going to hurt our position as being leaders and financial leaders and entrepreneurial leaders, et cetera. We’re drowning in national debt because of our health crisis.

44:18 Obesity as an International Crisis

Wendy Myers: So why don’t you talk a little bit about the fact that in the United States, two-thirds of the population is obese because of our diet? And we’re finding in other countries in India and China, et cetera and the large cities where they’re serving fast food and more and more of the upper and middle classes are eating fast food or have access to it.

They are having a huge problem with developing the same diseases that are so rampant in the United States. People in other countries are moving away from their traditional diets, their healthy diets of meat, vegetables and rice, et cetera in rural China or rural India and now they are suffering from the same diseases.

David Ludwig: All the peasants in China eat a lot of white rice. That’s a processed carbohydrate and they didn’t get obesity or diabetes. But they were working 14 hours in the field and that white rice wasn’t making them feel very good, but it was keeping them alive.

They move to the cities, which is happening now, bringing their highly processed carbohydrate diet, but leaving behind all that physical activity and rates of obesity and diabetes are skyrocketing. One recent estimate suggests that there may be close to a half a billion people in China with diabetes or pre-diabetes. It was half the country.

How do you get your mind around that kind of an estimate? So we have a true international crisis on diet-related diseases. We have to bring back sanity. We’re just going to be eating ourselves to death here.

Wendy Myers: Yeah. You have to eat the diet that’s based on your level of physical activity and where your body is using that up like athletes or people, like you said, working out on the field. They can handle that high level carbohydrate, but in the absence of that…

David Ludwig: It still may not be ideal for them. I mean there’s some very interesting work about lowering carbohydrates for optimal fitness. There are ultra marathon runners who can do it with no carbohydrates. They’re just one a ketogenic diet. No, I’m not recommending that.

We don’t need processed carbohydrates at all. We do need grains because we can’t support the world’s population without grains. But it can be in a much less processed state, slower digesting with many more nutrients, more fiber and the like.

47:02 Where to Find Dr. Ludwig

Wendy Myers: Dr. Ludwig, thank you so much for your insight. I know the listeners are going to enjoy that so much. I learned a lot myself. Why don’t you tell the listeners where they can find you and find your website and your book?

David Ludwig: Sure. It’s great talking to you, great questions. So the book is available widely now. It just came out last week. Website is DrDavidLudwig.com. And the book is now available on Amazon, Barnes & Noble, Costco, Sam’s Club and your local bookstore.

Wendy Myers: Is there anything else you want the listeners to know that perhaps we didn’t touch on?

David Ludwig: Well, I would say my mantra is the Michael Pollan-esque fashion, forget calories, focus on food quality and let your body do the rest.

Wendy Myers: Yeah. Thank you so much, Dr. Ludwig. I really appreciate that.

David Ludwig: It’s great talking to you.

Wendy Myers: And listeners, if you want to learn more about me, you can go to myersdetox.com and know all about my healing and detox program on MineralPower.com. Thank you so much for listening to the Live to 110 Podcast.