Episode 14: Taking a Deeper Dive into Eat Fat, Get Thin with Dr. Mark Hyman

• Why were these studies showing the benefits of a high fat diet largely hidden from view despite coming from top tier scientists?
• How did we so deeply lose our way (as we gained weight?)
• Hear about a JUST PUBLISHED study (not in Mark’s book) re-evaluating the research findings of the original anti-fat crusader Ancel Keys
• Is there value in the very low fat diets promoted by Ornish and Esselstyn?
• What high-fat scenario will actually lead to serious metabolic trouble?

Podcast sponsored by Designs For Health, Dr H Rejoint & Genova Diagnostics

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Podcast Series sponsored by Designs for Health

Kara Fitzgerald: Hi everybody, welcome to New Frontier is Functional Medicine, I’m Kara Fitzgerald. Today, I’m thrilled to have Dr. Mark Hyman with me. I think that Mark’s really brought functional medicine into mainstream consciousness, brought it to the greater medical community, really more so than almost anybody I can think of. He’s really done us a profound service in shifting the medical paradigm. As you probably know, he’s a practicing family physician, he’s a nine time, number 1, New York Times best selling author, he’s an internationally recognized leader, speaker, educator, and just a great, great advocate in our field. He’s the director of the Cleveland Clinic Center for Functional Medicine, he’s also the founder and medical director of UltraWellness Center, chairman of the board at the Institute for Functional Medicine, a medical editor at the Huffington Post, and he’s been on TV all over the place.

I also want to add, for professionals, that Mark and I co-authored in case studies in integrative and functional medicine. He contributed to the textbook for functional medicine and he’s published numerous peer reviewed journal articles, and we’ve published, I think, at least 4 together. Mark, it’s wonderful to have you. Thanks so much for joining me today.

Dr. Mark Hyman: Thanks for having me.

Kara Fitzgerald:Let’s just jump right in. We’re talking about your new book, Eat Fat, Get Thin. I’ve enjoyed reading it quite a bit. You’ve really done a remarkable job tussling with the science behind fat, really great job, lots of epidemiological studies, lots of fatty acid biochemistry, just good, good, good, good work. You site study after study from the 1800s on up, where the conclusion is always fat isn’t the culprit, sugar and carbs are. You mention Dr. Harvey and Dr. Osler in the 1800s, Joslin in the 20s, then you go to Willett in the 2000s, and on and on, really advising low carb diets for weight loss, reduced cardiovascular disease, reduced diabetes risk. What happened? How did we lose our way?

Dr. Mark Hyman: Well, we kind of got confused because we know that, from a pure common sense point of view, that fat seems to be what’s lining our arteries, if you eat fat you’re going to get fatty streaks in your arteries, it’s logical, and that fat has more calories than carbs and proteins, more than twice as many, in fact. Of course, if you eat fat, you’re going to get fat. The problem is, science just doesn’t line up around that because biology is complex and metabolism is not a math problem. It turns out that it’s sugar, not fat, that actually drives the kind of lipid abnormalities that actually cause heart disease. We jumped the gun on this. It’s fascinating, I just came out with this paper, yesterday in fact, which has an incredible story of how we went wrong, where it was a researcher who was partnered with Ancel Keys, who came up with the concept that saturated fat causes heart disease because it raises cholesterol, and if we lower saturated fat we reduced cholesterol, we reduced heart disease.

This was the basic mantra that led to our food policy. Yet, it was really never proven. A lot of it had to be based on observational data, so they did some RCTs in the 60s to try to prove this. A lot of them were buried because they didn’t actually prove what the authors wanted them to prove. In fact, one was published yesterday, after 40 years, which was a fascinating story. Ancel Keys, one of his colleagues in Minnesota, did this research called the Minnesota Coronary Study, and they looked at over 9000 people in mental hospitals. Now, you can’t do these studies now because you can’t, [inaudible 00:04:07] wouldn’t approve the, they would not approve of you do an experiment on people in a mental hospital, but then it was approved.

They found that when they give them corn oil, their LDL cholesterol came down, compared to saturated fats. They basically ran them as a trial of saturated fat versus corn oil, omega 6 oils. Even though the LDL came down, the risk or cardiac events went up. It was not the saturated fat that was the problem, it was the omega 6 fats, yet the entire government policy and our whole mantras are need more polyunsaturated fat, less saturated fat. This data was buried and the guy who did the research didn’t publish it. The son, who’s still alive, of this guy, is a cardiologist and this researcher, and I found out about him, went to him and said, “Do you have the data somewhere?” He’s like, “You know, I think my dad has a bait in his basement, maybe there’s this file, this box, I don’t know.”

They found this data from this research, and they published it. It showed these findings which completely contradict everything we thought.

Kara Fitzgerald: That’s incredible.

Dr. Mark Hyman: It’s not just one study, there [inaudible 00:05:18], there are many, many studies that point to the same phenomena where saturated fats are not the issue and refined vegetable oils are not the benefit that we thought. If they’re in the context of a rich, omega 3 diet, yes, but not in the context of high omega 6s by themselves.

Kara Fitzgerald: That’s amazing. Where was it published? Where is that if we want to access it?

Dr. Mark Hyman: Where is it? How do you find it?

Kara Fitzgerald: I know, I know.

Dr. Mark Hyman: It was published in the British Medical Journal and the, it was February … Let’s see, it was BMJ 2016, volume 365, I think page 2 through 26. It’s an open access journal so you can actually get it. It was called the Reevaluation of the Traditional Diet and Heart Hypothesis and Analysis of Recovered Data from the Minnesota Coronary Experiment. It was Dr. Hibbenn and Ramsden, so it was quite fascinating how they actually went back into the data and then reanalyzed it.

Kara Fitzgerald: Incredible.

Dr. Mark Hyman: It’s just on a pile of other data that shows through the observational data, even still doesn’t suggest that very well. When you do a more robust analysis and when you look at the plasma levels of fatty acid. There was just a study a couple of weeks ago looking at saturated fat and diabetes. They looked at not just observational data, they looked at actually fatty acid levels in the plasma, which is much more predictive of dietary history. Instead of saying, “What did I eat last week?” They’re actually measuring, “Oh gee, there’s butter in the blood.” What does that mean? They found that the highest levels of dairy fat, correlated with the lowest risk of diabetes.

Kara Fitzgerald: Amazing.

Dr. Mark Hyman: In other words, when you see the patients who are eating more butter, they have 40 and 50% lower risk of diabetes.

Kara Fitzgerald: That’s great. That’s great.

Dr. Mark Hyman: This was done by Mozzafarian, Thompson, these are many researchers, this is not stuff on the margins.

Kara Fitzgerald: No, I get it. I get it. You’ve got great, great citations in your book. All right, so that said, Dean Ornish is still advocating maybe 10% fat in his program, Esselstyn, who’s over at Cleveland Clinic, is advocating for even less. What are your comments on that? I do see some turnaround.

Dr. Mark Hyman: Absolutely. I did actually review, I wrote a blog recently called Fat, What I got Wrong, What I got Right, because I actually made a mistake in reporting some of the numbers from Dr. Ornish’s trial in the book, because I compared the groups, the control and the experimental groups, at the end of the study, to each other instead of from baseline. Normally you can do that because the groups are matched controls. His were not matched controls, they were mismatched controls because his group weighed 35 pounds, on average, more than the control group. There was a bigger weight loss in his group, although at the end, his group still weighed more than the control group. I kind of got that wrong, and it was just bad, I didn’t read the baseline data and I made that mistake.

I did talk about the issue, which is that, what is the best diet? Now, the concern is that if you see these interventions done, they do show this improvement, so is it the fact that it’s a low fat diet or is it the fact that they exercised, stopped smoking, the fact that they had social support and meditation, yoga? Or, is it the fact that they stopped eating the traditional American diet and ate a whole foods, plant based diet, even if it was low in fat? I think that the view that I really come to after looking at all of the data is that, if you’re comparing a traditional American diet, which is processed food, sugar, flour, a lot of omega 6 refined oils, to a whole foods, plant based diet that’s low in fat, they will do better every time, for sure.

What if you’re comparing a whole foods, low fat, plant based diet to a whole foods, high fat, mostly plant based diet that includes healthy animal products? How will that work? I think there has been some experimental data on that, there’s been some small observational data, and I think that we need to do the interventional trials. I’m actually looking at doing that with Steve Nissen, here at Cleveland Clinic, who’s a cardiologist who’s very interested in actually looking at these issues. I think we have to answer that question.

Do I think that Esselstyn and Dean are right in providing a whole foods, plant based diet? Yes. Do I think that they may be wrong in the fat story? Absolutely. I think I covered that. If you look at the data, the trends in his numbers from the LDL and HDL, the trends were to have a lower HDL, higher triglycerides, so he did drop the LDL, but when you look at the data on LDL, LDL isn’t actually the best bio-marker for cardiovascular disease, it’s LDL particle number and size. When you just look at LDL, you can actually have a very low LDL but very high numbers of particles, small LDL, and they’re the highest risk group. Whereas people who have a very high LDL, but very low particle number, and very large particles, and they have very low risk.

When you look at the correlates of that, if you see high triglycerides and low HDL, that always correlates with atherogenic dyslipidemia, it’s the pattern that you see. You’ll see small LDL, you’ll see large triglycerides, and small HDL, that’s called atherogenic dyslipidemia. In his trials, in these trials, you always see higher levels of triglycerides and lower levels of HDL.

Kara Fitzgerald: Yeah. Well, there you go. It will be really interesting to see what you guys do over there at Cleveland Clinic. I’ll be paying attention. 2015 dietary guidelines come out and cholesterol is now okay, dietary fat is okay, but with the exception of saturated fat. What do you think about these guidelines? It seems like they’re a step in the right direction, but …

Dr. Mark Hyman: Yeah, they’re a step in the right direction. We got rid of limits on dietary cholesterol, we got rid of the restrictions on total fat. However, they’re still saying to lower saturated fat. I think, every day, there’s more data coming out. Since those guidelines came out, the dairy fat study came out in diabetes, this latest study showing the randomized trial, which is again, very hard to do and there are very few of them, but I think a 9000 person randomized trial, that’s impressive, in the mental hospital where we actually get the data, that means something. I think the edifice of saturated fat being the enemy is coming down. There’s less and less data linking it, and in fact, more and more data is showing that it’s really not an issue.

I don’t think it’s a health food, but I don’t think it’s harmful, I think it’s probably either neutral, and it may actually, if you look at the effects of saturated fat on lipids, you can see that it improves lipid particles. It actually causes increases in LDL particle size, decreased particle number, increases HDL. There are very few things that increase HDL, saturated fat increases HDL. Coconut oil, which is 90% saturated fat, has the biggest impact on HDL, and it improves the LDL to HDL ratio the most. I think it’s really powerful when you actually think about looking at these things in a smart way, you can really just see that when you look at the … Here’s what’s so big about functional medicine, you actually begin to understand the underlying biology and that’s what helps you inform your decisions.

If you understand that it’s atherogenic dyslipidemia that causes heart disease, not just LDL, if you understand what causes that, it’s refined sugars and carbs, if you understand what fixes it, it’s good fats, even saturated fat, all of that plays a role.

Kara Fitzgerald: Yeah. Thank you, that’s great. Just really nicely, clearly articulated, because it’s complex. This is complex biochemistry and the interaction among these various macro-nutrients is powerful and profound. I liked, in chapter 5, which is really a good chapter in your book where you tussle with the science a lot, you talk about this massive 2014 review led by Dr. Chowdhry, really looking at fat and heart disease, again. You spent a good amount of time on that, and I know you’ve already mentioned some of those points, but talk about that study and how it’s influenced you.

Dr. Mark Hyman: Well, you know, that’s a study … There’s a lot of criticism of this study. It’s like, what’s the context of this diet and so forth. This study was a meta analysis, which has its own challenges. What they did was they looked at 600,000 people, 19 countries, 72 studies, RCTs, observational data, and plasma fatty acid studies. They basically concluded that there was no link between total unsaturated fat and heart disease. What was even more fascinating to me was that there’s a table, if anybody’s sort of geeky they can look at the table in that article, and you may even see trends. You see trends, for sure trans fat is harmful, everybody can see that. Omega 3 fat is beneficial. But, there was a trend towards butter fat, basically, being protective and omega 6 fats being harmful. They weren’t statistically significant but you could see the trend lines.

I think it’s pretty fascinating, when you look at that data, and it’s not just that data, there’s that other data by Dr. Krause, who’s done a lot of the pioneering research in this. He did a meta analysis over 350,000 people, 23 years, looking at saturated fat and heart disease and could really find no link. I think when you see that the even change palmitic and stearic acid, that these correlate with heart disease. These are fats that are saturated fats in the blood that do correlate with heart disease. Here’s the big thing that I learned when I researched the book, was that the fat that you eat doesn’t turn into the fat in your blood. In fact, when you eat saturated fats, even if you double or triple saturated fats, it doesn’t translate into those saturated fats in your blood.

When you look at the cause of palmitic and stearic acid, it’s not from eating palm oil or beef, it’s actually from eating sugar and starch that drives lipogenesis. That’s really what’s caused this. Saturated fat actually doesn’t impact that. In the odd chain, where margaric acid, which is from dairy, can be associated with reduction in risk. Also, arichidonic acid, which we always thought was bad, eggs, poultry, and beef, have more arichidonic acid, they were showing some reduced risks. Then, when you look even the nurse’s health study, when they controlled for fiber, saturated fats were not associated with heart disease in the nurse’s health study. In the RCTs of all the guidelines that we’re, and the RCTs on all the trials on fat before 1983 when the guidelines were established, there was no link in saturated fat and heart disease, this is from Open Heart Journal from 2015.

Then, when you look at the feeding studies, which is fascinating to me, because, okay, what about inflammation and saturated fat? What about oxidative stress? What about all these issues that we always think are a problem? Well, if you do feeding studies you can see what happens to people. They put you on very low carb diets, like 12%, high fat, very high fat diets, 8 men, 6 weeks, either omega 6 fats, not for the omega 3s, the high end 6, and saturated fats which was about 86 grams, that’s like 750 calories, that half of your diet in saturated fats. They looked at plasma lipids, cholesterol, inflammation, doubling of the dietary intake of saturated fat had no impact, no impact on plasma saturated fat. The ones who had the saturated fat, highest group of saturated fat, had the lowest inflammation, the lowest oxidative stress, they had lower insulin, lower triglycerides, and more enlarged LDL.

Kara Fitzgerald: Amazing.

Dr. Mark Hyman: The problem …

Kara Fitzgerald: Yeah, go ahead.

Dr. Mark Hyman: Can I say one more thing?

Kara Fitzgerald: Yeah.

Dr. Mark Hyman: I want to just make one really important point here. That sweet fat is deadly. Sweet fat is saturated fat with carbs, donuts, french fries, ice cream, bread and butter. These are deadly because you increase insulin with the carb, and you have the fat running around in your blood at the same time. It gets stored, it becomes inflammatory. That’s where the problem is.

Kara Fitzgerald: Got it.

Dr. Mark Hyman: Inflammation only occurs in the context of refined sugar and fat, and in the context of low omega 3 fats. If you add omega 3s, and you cut out the sugar and starch, or dramatically reduce it, it’s okay.

Kara Fitzgerald: You know, that’s exactly actually … You went exactly where I was going to go. That’s just exquisitely important, and something that I’ve observed just looking at zillions of fatty acid panels, looking at palmitic and the medium chains, et cetera. I know you have too. You see that pattern over and over again, high fat intake, tons of carbohydrates, simple carbs, you just see this massive hyper triglyceridemic picture. It’s potent and it’s inflammatory, arachidonic acid is also driven by insulin, and you see that elevated in this population. I highlighted that in your book because you said it, it’s the high fat intake, the sweet fat as you said, easy, sweet fat, that’s the deadly combination. Bravo.

Then, I guess this … In your mind then, it sounds like you’re concluding that, would you say a high meat diet is a reasonable thing? Where are you at?

Dr. Mark Hyman: High meat?

Kara Fitzgerald: Yeah, meat. Where are you at on the meat issue?

Dr. Mark Hyman: Okay, so this is a separate issue. Okay, separate issue. Separate issue. Meat, should we it? Should we not eat it? What’s the deal? Is it good? Is it bad? I think we so are confused about this issue. I was confused about it. Look, I want to live to be 120 so I don’t want to eat meat if it’s going to kill me, right?

Kara Fitzgerald: Mm-hmm (affirmative).

Dr. Mark Hyman: What I think is really critical is for us to look at these factors, and there’s 3 factors. One is, do these things cause disease? That’s the most important question, help or not help. Then, there’s the moral issues, which I think are an individual, if you’re a [inaudible 00:20:31] okay, don’t eat meat, I’m okay with that, I’ll support you in doing that. Second is, what about the environmental issues? Those are real. I think we have to be very cautious about that. I think we can’t ignore that and how we grow meat. We have to take that into account and how our factory farming is degrading environments. Let’s just assume we’re not factory farming and we’re eating grass fed meat, and we’re eating the healthiest types of animal foods, good or bad?

Then, I went and looked at the data. I was like, “Wait a minute? What is actually happening here?” It’s confusing because on one end, you see there’s concerns about saturated fat, there’s concerns about inflammation, cancer risks, diabetes, [inaudible 00:21:22] hydrocarbons and all this. You kind of go, well, what does the data say? You see studies like with the plains Indians and they ate buffalo and they have the highest centenarians in any per capita population in history. Then you got the seven like one of the blue zones and longevity folks, they’re vegetarians. So, what’s the deal?

There’s a lot of ways we can eat to stay healthy. I think that’s really true. Most of the research in meat is basically observational data, there’s a lot of confounding factors, and it’s confusing. These food frequency questionnaires, what was the population like, were the meat eaters healthy, unhealthy? If people weren’t eating meat was it because they heard meat was bad and they were actually having all of these other habits? Observational data is really challenging. You look at the NAHARP study and they had 100,000 people there’s a high risk of heart disease, cancer, death, bad, right? When you look at the data on these meat eaters, they smoked more, they weighed more, they eat more sugar, they drink more alcohol, have less fruits and vegetables, had 800 more calories a day, and took less vitamins. It wasn’t grass fed meat, it was capo meat.

Then you look at the epic study, on the other hand, the epic study showed there was half a million people, no association with unprocessed, fresh meat, but association with processed meat. 1.2 million people, another meta analysis, no link between meat and heart disease, diabetes, or stroke. Then, there was some other studies, like Asian studies, showing 300,000 people with increased meat in the context of a healthy Asian diet, actually associated with a decrease in heart disease and cancer. Then, I saw this one study that kind of answered a question, which is what if you had a healthy diet and you ate meat? Not that you’re a typical meat eater. They actually found this study where they looked at 11000 people, vegetarians and omnivores who shopped in health food stores. For both, the death rate was cut in half, they were equivalent.

I think if you eat meat in the context of a healthy diet, I don’t think it’s a big issue. Saturated fat in meat doesn’t raise blood cholesterol, that’s clear. We know that’s it’s mostly stearic acid, which is neutral. We know that in interventional studies, paleolithic diet interventions where they’re using animal foods, they see better outcomes in body weight, body fat, muscle mass, metabolic rate, lipids, blood pressure. I think the TMAO story’s a longer story, I don’t know if you want to get into that, but there’s some challenges with that, cancer risks. A lot of the cancer risk is based on processed meat, even it’s observational data and there’s some mechanistic explanations. The data is kind of weak, your risk goes from 2.4 to 3.2 absolute risk increase, which is not a very big, absolute increase in risk.

Kara Fitzgerald: Do you have anything to say about the TMAO story? I don’t know, I don’t know that it’s super strong at this point.

Dr. Mark Hyman: I do.

Kara Fitzgerald: Yeah, go ahead.

Dr. Mark Hyman: TMAO is … Here at Cleveland clinic, Stan Hazen has looked at TMAO, which is trimethylamine N-oxide, which is a metabolite that is produced in the gut from certain microbes that occur when you eat meat. The truth is that one of the highest sources of TMAO is actually fish, which is supposed to show a decrease [crosstalk 00:24:37]. So that’s a little confusing. Then, it’s produced from dysbiotic bacteria from carnitine, choline, lecithin. Vegetarians who ate steak, they showed no increase in TMAO. If you give them antibiotics, it prevented the TMAO after meat consumption. If you had olive oil, red wine, and balsamic vinegar, it also limited the TMAO in the production.

The highest concentrations are in fish. The fact is that how do you have a healthy microbiome, more like a vegetarian? Do you eat more vegetables? I don’t think you necessarily have to eat no meat, because I think it’s really about what the overall health of your gut microbiome is. You and I know, being functional medical doctors, know this.

Kara Fitzgerald: Thank you. Yeah, that’s a great summary and that makes a lot of sense. I think some people, well, yeah, definitely, the gut microbiome is a piece in this story. Again, you’re coming back to your central thesis around having a healthy, whole foods diet, and if you want some meat, that’s okay. Well, you know, jumping off of that, what are you eating these days?

Dr. Mark Hyman: Well, I eat a pretty simple diet actually. I decided to just eat foods that make me feel good, and taste good. For breakfast, I’m a pretty busy guy so I’ll have either a few eggs and avocado, maybe a slice of tomato and some olive oil. I call it a fat on fat on fat, right? Olive oil, eggs, avocados. Then I’ll have a fat shake, which is nuts, and seeds, which have fat, almond butter, coconut butter, coconut oil, and coconut milk maybe. Then I’ll toss the added fiber in, and blueberries, and that’s my fat shake. For lunch, I might have what I call a fat salad which is, I’m sort of making it tongue in cheek about this but it’s basically lots of veggies, and the crunchy veggies, then I’ll put avocados, pumpkin seeds, maybe a can of wild salmon or sardines on the side, and olive oil. It’s fat on fat on fat on fat.

Dinner’s usually a piece of fish or chicken, I don’t eat that much chicken but cage free, grass fed lamb, maybe once a month I’ll have a grass fed meat. Then, lots of veggies, 3 quarters of my plate is veggies. I’ll have a huge side of broccolini, I’ll have, maybe, an extra salad, or I’ll have sauteed mushrooms, or I’ll cauliflower. I’ll have a lot of different vegetable dishes, and I just fill up on that. If I want dessert, I’ll have, maybe I’ll have some frozen blackberries, which are full of antioxidants, low glycemic, and I’ll put a can of coconut milk in them.

Kara Fitzgerald: Yum. That sounds really good. Okay, all right, got it. Lots of fat, not a ton of meat, a little bit, some fish.

Dr. Mark Hyman: Yeah, I call it a pegan diet.

Kara Fitzgerald: Oh, that’s your … Okay, the pegan diet.

Dr. Mark Hyman: The pegan diet, which is basically mostly plants. It’s like Michael [inaudible 00:27:37], mostly plants, not too much, right?

Kara Fitzgerald: Yeah. All right. You mention that this book was the hardest you’ve ever written. I have my opinion on why that might be, but why was this book so challenging for you?

Dr. Mark Hyman: Because sugar is easy, everybody’s like, “Sugar is bad.” Everybody knows about insulin resistance. It’s an easy, straight forward concept. Fat is extremely polarizing. In fact, I have been attacked for my views based on this book. I never was attacked before. There’s a low fat crew, there’s the Ornish, Esselstyn, Barnard, Colin Campbell group. Then there’s the Paleo groups, then there the keto groups. It’s an interesting dynamic of controversy. Then there’s the science, which was like, “This is confusing.” I realize that even though I’ve studied this for years, I think my understanding of this was not as deep as I actually thought. I realize I didn’t really know all the literature on omega 6 fats, I really didn’t know all the literature on meat, or saturated fat.

I had a top line level understanding, but I really, really needed to know more. That’s why I dug in. I found so much controversy. I talked to Walter Will and on one hand he’s like, “Omega 6, we should be drinking vegetable oil all day.” Then there’s guys from the NIA, like Hibbenn and Ramsden are like, “No, this is bad and here’s why.” Then you’ve Krause saying saturated fat is fine, then you’ve got other docs saying it’s really bad. I think it’s confusing.

Kara Fitzgerald: Mm-hmm (affirmative).

Dr. Mark Hyman: That’s why it was hard.

Kara Fitzgerald: Yeah. Understandably. Seriously, that’s what I was … Yeah, yeah. There’s so much data that you’re sifting through here and really making sense of

Dr. Mark Hyman: I did my best. I don’t know if I got it all right, but I did my best.

Kara Fitzgerald: Yeah, I get it Mark, I really do. Just me, being in the laboratory, and we thought, we wrote on fatty acids, lectured on them, I looked at tons of data, I measure them in my patients, I thought that I had a decent grasp on it as well. I just, when I was reading your book, I just absolutely appreciated the depth and you opened my eyes in just distilled and refined, and brought this into clarity, far more so than I’ve encountered, and definitely in my own background, so thank you. I just want to summarize. Saturated fat is fine, and in fact, it’s absolutely beneficial, except in the context of simple carbohydrate and sugar, or sweet fat. Omega 6 fatty acids, to summarize, are less beneficial overall. Omega 3 fatty acids are beneficial.

Trans fats are obviously out. Not all saturated fats are created equal. We make tons of saturated fat, palmitic especially, at the direction of sugar and insulin, but the medium chain fatty acids, found in coconut oil, are remarkably useful. Some of the longer chain fats, I think, are good, or neutral, as you said. Would you say that’s a reasonable summary? Any clarifications there?

Dr. Mark Hyman: Yeah, I think you’ve got it right. I think you got it right.

Kara Fitzgerald: Awesome, okay.

Dr. Mark Hyman: I believe that’s it, you got it. All of it’s, by the way, in my book. If people want to know about it, it’s all in there.

Kara Fitzgerald: Yeah, it is. Okay. Now, I was just reading the other day that you did a grand rounds over at Cleveland Clinic. I’m completely switching gears now because I just want to grab you for our final few minutes here. You just did a grand rounds over at Cleveland Clinic, so we’ve got a functional medicine there, which is amazing, amazing, amazing. You’re really expanding the reach of what we’re doing, and I know it’s wildly popular. You’ll probably end up seeing my family, I told you at the beginning of this call I’m from Cleveland, so my family’s always asking me about it. You just did a grand rounds to the greater medical community there at the Cleveland Clinic on a functional medicine approach to autoimmunity. How was that received?

Dr. Mark Hyman: I wish you were here with me Kara, because you would just have your mind blown by the level or interest, excitement, enthusiasm, collaboration, hunger for what we’re doing. I always expect to get boo-ed out of the room. They’re not, they’re like, “How do we work with you? What do we do? How do we collaborate? We want to do research together. Can I send you my family? Can I come see you? How do I get an appointment?” It’s just kind of stunning, sometimes it’s like I’m pinching myself. You might know, we’ve been doing this forever, and I’ve been doing it a little longer than your forever, but it’s just stunning to see this.

Kara Fitzgerald: I’m sure, I’m sure it is. It’s like goosebumps just listening to it. You know, I’ll tell you, from personal experience, when my dad goes to his Cleveland Clinic cardiologist, and of course, he talks about my background, and my sister goes to her Cleveland Clinic doctor periodically, they always bring up functional medicine. It’s true, the doctors there are really excited. My family comes back and just says, “You know, my doctor wants to know this, and this, and this.” You’ve lit a fire over there, at Cleveland Clinic, this excitement. I feel it just from my family talking about it, and of course just paying attention to what you and Patrick are doing, that great team that you’ve built over there. Bravo.

Dr. Mark Hyman: When are you coming to work with us? When are you coming over?

Kara Fitzgerald: I’ll be there.

Dr. Mark Hyman: We really need you.

Kara Fitzgerald: You know, I would love …

Dr. Mark Hyman: Actually, I was just going to call you because we want your help. We’re building all these practical guidelines, we want to bring thought leaders together, we want to bring out good old practice guidelines and protocols, we really want your help doing that.

Kara Fitzgerald: Absolutely. Yeah, yes. I participated in the one on asthma. I would absolutely jump in again, for sure. Okay. Let me just ask you a few more questions here. Really being at the front of the movement and just seeing this expansion that seems to be becoming exponential at this point, where is functional medicine headed?

Dr. Mark Hyman: I think we are really poised to be the future for chronic disease in this country. Here at Cleveland Clinic, we’re given the opportunity to innovate and really transform the kind of care model they have here and do population help, where we’re actually doing community based work. The opportunities are really happening. The research is happening, the clinical care is happening, the policy care is happening. It’s a perfect storm of really amazing things that are accelerating the development and growth of functional medicine.

Kara Fitzgerald: That’s just wonderful. I, just hearing you say earlier, too, that you have these certain questions, and you’ve got the scientists right there at the Cleveland Clinic, now. You’re not just fantasizing in your Lenox center on studies you’d like to research. Now that we’re at the Cleveland Clinic, you can actually start to research these questions that you’re developing in your process of writing. This more detailed investigation around fat in a whole foods diet versus no fat in a whole foods diet, you’re actually going to participate in answering it.

Dr. Mark Hyman: Absolutely. We’ve got Steve Nissen, who’s one of the world class cardiology researchers, and he’s excited to work with us to answer these questions, which is super exciting.

Kara Fitzgerald: Very, very exciting. Very cool that you’re getting to participate in that. I also, I meant to ask you this question earlier, you have some nice outcome data on people who have followed your eat fat, get thin protocol. Anything you want to say?

Dr. Mark Hyman: Oh, yeah. Oh, sure. We had 1000 people do it, and had people do it, and we see this tremendous level of success. People who lose a tremendous amount of weight, it improves their blood pressure, blood sugar, and we had … People had the biggest reduction in the MSQ, which is a symptoms score, which is pretty cool. A 68% reduction in all symptoms from all diseases in just a very few days.

Kara Fitzgerald: Incredible.

Dr. Mark Hyman: That’s pretty remarkable when you think about that. We’re able to achieve that through very simple interventions. Very, very exciting.

Kara Fitzgerald: That people lost weight, their blood pressure dropped, their blood sugar dropped, and on and on. [crosstalk 00:36:47] Yeah, very good. There’s a lot of MD’s, a lot of clinicians all over the place in a variety of specialties, MD’s are moving into functional medicine quite a bit. I have an MD in my practice now who needed to make this transition to keep his career, to just find his heart in medicine. For new doctors, not new doctors, but doctors new to functional medicine, or transitioning into function medicine, any words of wisdom to them? Maybe your own process, any advice?

Dr. Mark Hyman: Yeah. I think people are excited about the future, they should take the time to really learn about how their practices can be transformed by using this overall approach. I think, it takes a little time, it takes a little effort, but learning it an applying it, starting simply, can give us just really profound effects. Come and get trained with us for functional medicine.

Kara Fitzgerald: Thank you. Mark, it’s been great to talk to you. I know you’ve got to scoot, but just really great job. I look forward to seeing you in May. Thanks so much.

Dr. Mark Hyman: Thank you.

Kara Fitzgerald: All right.

Mark Hyman, MD, believes that we all deserve a life of vitality—and that we have the potential to create it for ourselves. That’s why he is dedicated to tackling the root causes of chronic disease by harnessing the power of Functional Medicine to transform healthcare. He is a practicing family physician, a nine-time #1 New York Times bestselling author, and an internationally recognized leader, speaker, educator, and advocate in his field. He is the Director of the Cleveland Clinic Center for Functional Medicine. He is also the founder and medical director of The UltraWellness Center, chairman of the board of the Institute for Functional Medicine, a medical editor of The Huffington Post, and has been a regular medical contributor on many television shows including CBS This Morning, the Today Show, CNN, The View, the Katie Couric show and The Dr. Oz Show.