How to Fix Your Busted Metabolism

This episode explores practical strategies and scientific insights on revamping and optimizing metabolic health.

1. Metabolic Dysfunction Prevalence: A staggering 93% of Americans suffer from poor metabolic health, largely due to modern dietary habits and lifestyle choices.
2. Impact of Processed Foods: The episode underscores how processed foods significantly impair metabolic functions and contribute to a range of chronic diseases.
3. Personal Health Empowerment: Dr. Means advocates for personal empowerment in managing health, emphasizing the importance of understanding and monitoring one's own biomarkers.
4. Dietary Influence on Health: There's a strong focus on the impact of diet on metabolic health, with a call to return to whole, unprocessed foods.
5. Holistic Approach to Health: Both experts stress the need for a holistic approach to health that integrates diet, exercise, and a reduction in toxin exposure.

1. Introduction to Metabolic Health

Dr. Hyman introduces the topic of metabolic health, setting the stage for a deep dive into how lifestyle factors contribute to metabolic dysfunction. They discuss the alarming statistics around metabolic health in the U.S. Dr. Mark Hyman: "93% of Americans suffer from poor metabolic health, largely due to lifestyle choices."

2. Dr. Casey Means' Journey

Dr. Means shares her personal and professional journey, explaining her shift from traditional medicine to focusing on metabolic health due to its foundational impact on overall wellness. Dr. Casey Means: "I shifted my focus to metabolic health to tackle the root causes of chronic illness."

3. The Role of Diet in Metabolic Health

This chapter delves into the specifics of how diet directly affects metabolic processes, with practical advice on choosing foods that support metabolic health. Dr. Casey Means: "Whole, unprocessed foods are the key to improving metabolic functions."

4. Empowering Personal Health Management

Discussion on the importance of individuals taking control of their health through education and self-monitoring of health markers. Dr. Casey Means: "Understanding your biomarkers is crucial for taking control of your health."

1. Monitor Biomarkers: Regularly check key health markers like blood sugar and cholesterol to understand your metabolic health.
2. Reduce Processed Foods: Minimize intake of processed foods and sugars to improve metabolic functions.
3. Incorporate Whole Foods: Focus on a diet rich in vegetables, fruits, and whole grains.
4. Engage in Regular Exercise: Incorporate regular physical activity to enhance metabolic health.
5. Educate Yourself: Continuously seek knowledge about health and wellness to make informed decisions about your health care.

One of the many reasons I was drawn to Functional Medicine is that it’s the medicine of asking “why?” and looking beyond the status quo to reimagine health. When we use this practice to assess the metabolic diseases we see today, we can see we’re in an energy crisis. We’re wrapped up in a web of physiologic root causes, but also a web of policies, industries, and economic incentives impacting our health from the ground up. I loved discussing all this and more on this episode of the podcast with Dr. Casey Means.

People

Dr. Mark Hyman, Dr. Casey Means

Guest Name(s):

Dr. Casey Means

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Casey Means
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Terms and conditions apply if rated pg. Coming up on this episode of the. Document so you need to load the body with the highest quality food possible, unprocessed from good soil, because you are going to increase the probability that those little cells are going to have the right thing floating around them to do what you want to do, which is be healthy and not be sick. Before we get into today's episode, I'd like to take a minute to remind you of some exciting news. My new cookbook, the Young Forever Cookbook, will be released on Tuesday, June 4 nationwide.

Mark Hyman
In my new cookbook, the Cooking Companion into my book, Young Forever, you'll find over 100 mouth watering anti inflammatory recipes that are going to help you live a longer, healthier life. You can pre order the young Forever cookbook at young forevercookbook.com dot. Just click on the pre order button at the top right. I'm so excited to share these recipes with you and so much more. And again, the young forever cookbook comes out on Tuesday, June 4.

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Go to tryarmra.com mark and enter the code mark to get 15% off your first order. That's tryarmra.com mark. And now let's get back to this week's episode of the Doctor's Pharmacy. Welcome to the doctor's pharmacy. I'm Doctor mark Hyman.

That's pharmacy with an ethical place for conversations that matter. And today's conversation is about good energy. Who doesn't want good energy? You're going to love this conversation with a good friend of mine, a brilliant physician, doctor Casey means. She's a Stanford trained physician and co founder at Levels, a health technology company with the mission of reversing the world's metabolic health crisis.

Her book on metabolic good energy is out now. She received her BA with honors. An MD from Stanford, she's just a legend. She's a president of her Stanford class. She has served on the Stanford faculty, and she's also trained as a head and neck surgeon and left that amazing career to devote her life to tackling the root cause of why Americans are so sick and overweight.

She's been featured in the New York Times, the New Yorker, Wall Street Journal, Forbes, Women's Health, and lots more. And Casey and I dive deep into the topic of her new book, Good energy. You know, we all have bad energy. Our body's ability to make energy and our resulting fatigue and cognitive dysfunction and metabolic health dysfunction are all caused by a lack of proper energy. And we're going to get into what that means and why it's important, and how we have such an epidemic of poor metabolic health that affects 93% of Americans.

How her own story, through the discovery of this topic and through her mother's illness, changed her view of everything. She talks about how you need to trust your own body, not just the doctor, right? The most intelligent person in the room in terms of your own health is your own body. Don't trust the doctors. Don't trust the science.

Don't trust me. Trust yourself. We'll talk about that. It's a really interesting frame. We also talk about the six principles of good energy eating that can apply to any dietary pattern or philosophy, from vegan to carnivore, and simple rules when it comes to food and lots more.

Very exciting conversation about this, as well as things we can do to really fix our food policy system. So I hope you love this conversation. Coming right up with Doctor Casey means. Casey, it's so great to have you back on the podcast today, Mark. It's such a joy to be here with you always.

You know, I was thinking about both of us and how our medical careers took such a different trajectory. We were both trained in the orthodoxy of traditional, conventional medicine. Went to top medical schools, top residency programs. You were at Stanford, you were at the pinnacle of medicine. You were a head and neck surgeon.

You had this incredible career ahead of you. And then something changed in your mind about what you were learning. You realize that maybe the orthodoxy wasn't completely true. Not that it's all bad or wrong, but like something fundamentally was flawed about medicine and about how we were trained, about how we think about disease and health. You know, how we get indoctrinated in ways that make us blind to what's really true about human health and biology.

And I've heard you talk about this on other podcasts, and I just think you have such an incredible story to tell about being this top doctor at one of the top institutions in the world, and you're just like, nah, I'm getting out of that cult. What happened? I think that the easiest way to describe how I got out of the cult is that I did the most dangerous thing that you can possibly do. I think, as an american living today, which is you can start to ask the question, why? Why?

Casey Means
Why is it that I'm nine years into my medical training and I don't really understand why patients are sick? Why is it that we're spending $4.3 trillion on healthcare costs and we're getting sicker every year? Why is it that the more hundreds of millions of prescriptions for chronic disease and medications were prescribing, we're actually increasing the rates of the chronic diseases? Why? The more specialties that we literally invent in medicine, the sicker that we are getting, why?

The more surgeries we're doing, our patients getting sicker, asking the question why? This doesn't really make sense. So what's really going on here? And once you start opening that box, Pandora's box, it's like you can't go back. It's over.

Because you start to see that the true foundation that the whole system is built on is actually so fundamentally flawed that it's not going to be an incremental fix that gets us out of this monumental, you know, devastating hole that we're in in America, where literally we're getting sicker, heavier, more depressed, more infertile every year, life expectancy is going down and it's getting worse. We're not going to get out of that hole by changing, you know, a few words on the Medicare part D, page 250. It's gonna be a whole lot. Let's cover Ozempic on Medicare part D, the drug benefit that's gonna fix everything. Yeah.

So it's a wholesale reimagination of the foundation of the whole thing, of the whole healthcare system, of our relationship with our bodies and building it from the ground up. And that's why I wrote this book, good energy. And that's, of course, why I just so honor the work that you've been doing, because it's not about incrementalism, it's about following the rabbit hole of the question why? And getting to the root cause of why we're sick and reimagining the future of humanity, not just the healthcare system, but actually the future of human thriving. Wow, I love that.

Mark Hyman
That's so beautiful. And I think about the question why? It reminds me of a couple things. One, my mother used to say to me when I got home from school, mark, not what did you learn in school today, but what questions did you ask? What questions did you ask?

Question asker. I'm like that annoying kid in the front of the class, hey, what about this? What about that? And I literally would not leave a medical school classroom until I actually asked all the questions that I needed to know. And functional medicine, the way I describe it to people, is traditional medicine is the medicine of what?

What disease do you have? What drug do I give? Functional medicine is the medicine of why? Why is this happening? Why is my immune system so pissed off.

And I have an autoimmune disease, not what drug do I give it, and what do I call this particular disease? And when you start asking why, the whole world opens up and we begin to wonder, wait, wait a minute. We did not learn about health in medical school. We did not learn about anything that really matters, about how to create health for people. And my daughter right now, she's in her third year of medical school.

I said, rachel, did you learn about the microbiome? No. Did you learn about insulin resistance? No. Did you learn about the mitochondria?

Mitochondria? Well, the Krebs cycle in first year medical school, biochemistry. Did you learn about nutrition? No. And I'm like, well, what are you learning about?

These are the fundamental things that are wrong today in human beings in the 21st century that we have to address, that are at the root of our dis ease. And dis ease. And your book, good energy, the surprising connection between metabolism and limitless health is just a tour de force. I think even that's the quote I gave you on the COVID It's one of those books that I think is a paradigm shifting book, because it helps us to understand what's really at stake here, what the problem is with the why. The answers to all the whys of the questions that you were asking.

You went not just asked the questions, but you made sure you dug deep to find the answers of why, and then you built a sideways career. Not a head and neck surgeon, but you started a company. You want to empower people with their own health information about their own metabolism. And this is really what good energy sort of came from. Was this insight about what really matters, and how do we start to think about what's making so many people sick in this country?

And I talk about this ad nauseam. People are probably sick on the podcast, but metabolic health is the fundamental barometer of everything that's wrong with our society. Today we're seeing over 120 million Americans with prediabetes or type two diabetes. I think it's way more than that, because if 93% of us are metabolic and healthy, by the definition, according to NHANes trial, which is basically the government National Health and Nutrition Examination survey, it's a massive study. It's been going for decades and decades.

It tracks people's lab tests and all their biomarkers and their health status and basically said, hey, you know, like, 93% have high cholesterol, high blood sugar, high blood pressure, have had a heart attack or stroke or are overweight. 93% of us. And all of that. All of that is about metabolic health and good energy. Your book is really the insight into why that's happening, what to do about it, and how to fix it for yourself.

So everybody other than the 7% who don't need this book, 93% of you listening out there, have this. And, you know, I just to kind of go on for a second. I know this is your podcast. I could listen to you talk all day. One of the things that was striking is I co founded this company, Function Health.

You heard me talking about it, and we tracked over 3 million biomarkers now. And these are health forward people. These are not necessarily people who are just the average american, because they're early adopters, who are like, who are the first person iPhones or Apple watches? They're early adopters. 95% have elevated lipid particles, and 89% have elevated small lipid particles or ldl particles, and 56% have high apoB, which is a marker of poor metabolic health.

So you're looking at these numbers, and what do they mean? Well, they basically mean that we're seeing 89% of people, at least, have poor metabolic health in this group of people. And this was stunning to me. And I'm like, holy crap, we're in big, deep doo doo. So how we ended up like that, and how do we have people having this metabolic dysfunction, which at the root is something called insulin resistance, which is sort of the thing I talk about a lot.

But once you explain what that is and why we ended up like this, and why is it half or maybe more than half, maybe it's 93% of the population. And it's like, you know, it's a continuum. Like, you don't just go, I'm sick. You don't get pre diabetes one day and then diabetes another day? You have this continuum from wellness to illness, and this transition happens slowly over time.

And so this 93% is those people on that transition. Yeah. How do we get here? What do we do? And I so agree with you.

Casey Means
I think it's more than 93%, because if you actually look at the 93%, that's just looking at people who fall into the normal range for all the metabolic health criteria. But if you look at optimal range, I'd guess it's less than 1% of Americans are actually optimally healthy. I want to be in that 1%. I think you probably are, Mark. But to get at your question of how did we get here, where 93% or more of the american adults in our population have a fundamental problem with metabolic health, meaning how their cells are powered.

I could go into the food and the lifestyle and the sedentary behavior, and the systems issues, and Rockefeller and the bad economic incentives, and I'm sure we'll talk about all of that. But I think at the highest level, the real root of why we're here is fundamentally, it's about disconnection. And I think the way that I can most easily explain that is to just give people a picture of what happens. In your last year of medical school. You went through this.

I went through this. You are asked to choose from one of over 40 medical specialties, separate specialties, to devote your entire life to. And climbing the ladder in the western healthcare system means becoming more and more specialized on a smaller and smaller part of the body. That is success in our system. Like, if you're an otologist who focuses on a 1 cm² part of the entire body, that is prestige, and so you're in that system of hyper specialization, and what is built into that, fundamentally, is fragmentation.

It's an idea that the body is all these different separate parts that are disconnected. And so we have these fragmentation goggles as doctors that don't let us see the whole system together. And that affects every aspect of both how we practice medicine and treat medicine as this whack a mole game of symptom management, but also in the way we view the fundamental nature of the body. So in that system, it's almost blast me to ask the question, or think, how is erectile dysfunction connected to Alzheimer's dementia? That just seems so out of left field through our conventional system.

Mark Hyman
How's your microbiome connected to autoimmune disease or depression or autism? Right, exactly. It's all about disconnection. And actually, there's a disincentive to focus on other parts of the body from what you're specialized in. Because of liability, that's out of your lane.

Casey Means
What if you do it wrong? And that's a problem. And because of this, we don't have the basic framework to see the blaringly obvious fact that all of the symptoms and diseases that we are facing and suffering from in the modern western world are fundamentally the same disease. They are diseases of metabolic dysfunction, insulin resistance, as you said, it's like the. Blind man and the elephant.

Mark Hyman
All the specialists taking care of all the different parts of your body can't actually see the whole and don't understand the root causes. And it's what you're talking about. I mean, there's other things that drive it. But that's like, I have a huge one, disconnection. And I think, you know, the first part of my book is called everything is connected.

Casey Means
Cause I really do think that we could just keep throwing more money at the problem. But unless the actual foundation of what we're dealing with is true, is based in truth, which is an interconnected system, we're just not gonna heal. And I think, you know, a real call to action I have for people when reading this book is to re embrace an idea of connection on all aspects of our individual lives and of the system. And I really think about four main, key things. The first is this fundamental internalization that the root cause of most of the things that we are truly suffering from, that are shortening the lives of our parents, of ourselves that are hurting our children, are fundamentally rooted in the same things.

Metabolic dysfunction, insulin resistance, and how our cells power themselves, seeing that connection between all parts of the body. The second. It's an energy crisis. It's an energy crisis, an underpowering energy crisis that's manifesting in all these different trunks of that tree and different cell types as different diseases. So, number one is understanding that the root cause of what is making us sick is metabolic dysfunction.

The second piece of connection that people need to internal. Before you go to the second one, just. Just unpack a little bit. Specifically, the conditions, diseases that are linked to this, because people say insulin resistance, I don't want. Is that.

Mark Hyman
My doctor never talked to me about it. I never had a test for it. I don't know what she's talking about. What are the diseases? Just quickly, and then I want to hear your second point.

Casey Means
So, fundamentally, metabolic dysfunction, insulin resistance is a problem with how cells are powered, how these beautiful machines of our cells are powered. We have 40 trillion plus cells in our body. They all are doing trillions of chemical reactions per second. And every single one of those chemical reactions needs a currency of energy to pay for that work. That energy is ATP.

That energy is made by our cells, by our metabolic processes, to pay for all that work. In 93% of american adults, that process is damaged. The flow of food energy, which is a potential energy to human energy, which is ATP. That process is blocked. So that is the fundamental issue.

Mark Hyman
Ultimately, diabetes is starving in the midst of plenty, exactly like your cells are starving. Like type one diabetes, essentially is. They can eat 10,000 calories a day, but without insulin, it's not getting in the cells. So if insulin's not working properly, you're not getting the energy. So this is a really important point.

Casey Means
Absolutely. And every aspect of our rapidly changing environment has hurt this beautiful structure inside our cells, the mitochondria that converts this cosmic energy, food energy, to human energy. So we are blocking that miraculous flow of potential energy into human energy. And because of that, we have underpowered cells. And because we have over 200 cell types in the body, we have all these different types of cells.

We've got retinal cells, we've got astronauts, we've got glial cells, we've got hepatocytes, we've got kidney cells, we've got. We've got fibrocytes, ovarian Zika cells, myocytes. Because we have all these different types of cells, the underpowering of different cell types looks like different diseases. Cause, of course, the manifestation of dysfunction in a particular cell type will look different based on where it's showing up. And so to get to your question, what does that look like?

It can look like anything from polycystic ovarian syndrome, the leading cause of female infertility, to erectile dysfunction, fatty liver disease, stroke, heart disease, Alzheimer's, dementia, cancer, depression, anxiety, migraine, fibromyalgia. It can look like almost anything. Gout, premature blindness. And so, and people might say, God, these things are totally different. But the key thing that people need to realize is that these are different cell specific manifestations of the same underlying process, which is underpowering due to mitochondrial dysfunction that's caused by our modern environment, that is blocking us from converting food energy to human energy, that is the core of our metabolic crisis.

And that is what this book is about, is how to both understand that, learn about how that process is going in your own body, and then take the steps, the evidence based steps, to rapidly improve that in your own life so that we can cultivate the internal cellular life force that powers every cell of our body to do good work. And when we have cells that are functioning properly and are powered properly, that is health. Yeah. So, and that's just such a beautiful breakdown of this. And as you're talking, I'm just thinking, yes, we really don't think of medicine properly.

Mark Hyman
We don't think of this fundamental root causes. And what you're talking about, sort of even insight for me, I've been doing this for a long time, is it's linked to everything, right? It's heart disease, diabetes, cancer, Alzheimer's, fertility issues, mental health issues, on and on and on. And so the conditions that we're all suffering from, that we're all getting sick, all the things that you laid out at the beginning. The healthcare costs going up, the diseases going up are all related to this phenomena.

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One of the problems is, why aren't we fixing this? Like our healthcare institutions profit when we're sick. We lose money when we're healthy. The whole system thrives on perverse financial incentives. The more things you do, the more you get paid.

It doesn't matter if the patient gets better or not. We have a huge food industry in this country, $10 trillion processed food permanently. And healthcare is kind of a huge industry, all connected to this one problem. And it's all predicated on our disease care system and our dependency. In fact I think fast food industry is invested in by the insurance companies.

Casey Means
It's so dark. Yeah. And recently, I don't know if you heard this but the fast food makers and processed food makers called the CEO of Nova Nordisk stressed about losing their market or stomach share. So you know, why? Why is a system working like this?

Mark Hyman
Why is our help not a priority for these institutions? How do we take back control? Why is system so screwed up? It's very simple mark. It's a devil's bargain.

Casey Means
It's a devil's bargain that involves ten plus trillion dollars of industry that form a revolving door of customers. And I would say the two main industries that we're dealing with, like you mentioned, are the ultra processed food industry and the healthcare system which comprises hospitals, doctors offices, the pharmaceutical industry and insurance. And the stark financial reality is that every institution in America that touches our health makes more money when we are sick and they make less money when we're healthy. And as you know, healthcare is both the largest industry in the entire United States. And it's also the fastest growing industry.

It's a business that's designed to grow. And right now with the incentives that we have at play in the United States, the way that the healthcare system grows is more patients engaged in the system for a longer period of time. Having more things done to them and put into their bodies or taken out of their bodies. That is how the system grows. Reminded me, I don't want to cut you up, but I do.

Mark Hyman
I remember this slide I used show looking at the healthcare costs in 2000 when I started doing talks on this stuff. It was $1.6 trillion. Now it's 4.3 trillion. This is in 24 years. It's staggering, right?

Casey Means
Largest economy in the world, richest country in human history, 25% of the GDP and growing. It's wild. It's absolutely wild. And so you've got the food system that benefits, of course, and it gets its shareholder returns by having more people addicted to their products and essentially eating themselves to death through addiction to their food products. And then you have a healthcare system that happily is there to take on those patients who have made maid sick due to those ultra processed addictive foods.

And then of course they aren't incentivized, trained or taught or even have the framework, the connection goggles to teach the patients about how that food is related to their healthcare issues sends them right back out to eat that food. And it's food doesn't really matter. With this disease. Just do whatever you want? Yeah, whatever you want.

So it's just a. It's a profit cycle that's based in these stark economic realities. And I think it's probably similar for you as a doctor. Like, every doctor I know is a good person. They went into healthcare to help people.

But when you have $10 trillion of an invisible hand that has insidiously corrupted every aspect of the system, from the research that's published to how the medical school classes are taught to how you get paid in healthcare, what happens is that you become entrenched in a system that is abjectly harming patients when it comes to chronic disease management, which is now, of course, the biggest part of what we treat and also takes the wins we had in the last century of healthcare, which were all based on treatment of acute illnesses. And you take the trust that was engendered from that, and you ask people to trust the science with chronic illnesses, which has been an abject failure. And so that's what's happening in doctors. I think, in a sense, doctors are also victims. But I remember vividly when I was in my surgical residency, and I was heading into my fifth year of surgical residency, about to launch in the world as an independent surgeon.

And the doctors would sit you down at lunch, the attendings, and say, we got to talk about the business of this, because you're going to have to make money. And in surgery, the unofficial mantra and euphemism of how to make money as a surgeon is you eat what you kill. And that is dark. It's dark euphemism. That's one of the mantras you hear in medical school.

You do. You eat what you kill. And what that means, of course, it doesn't mean you actually kill the patient. Cause that would be losing a customer. But you are.

The amount of surgeries that you book will determine your livelihood. And so the nice way of saying that as a chance to cut, as a chance to cure, but it still incentivizes surgery, right? Yeah. And of course, that exact statement is why we all go into surgery. Those of us who go into surgery, it's a chance to cut is a chance to cure.

I remember deeply thinking you're at the end of medical school, and I'm like, I want to be a badass. I want to be hardcore. So I'm going to become a surgeon. I want that drill. I want that bone saw.

I'm going to get in there because I'm a badass. And you think I'm going to be a hero. And then the root awakening is to realize that what we've put on a pedestal in our society and our intervention first reactive system is that who is the hero? In medicine, when you think about the hero, you think about the old white guy in the operating room with a bone saw doing a heart surgery or doing a brain surgery. That's the hero.

And when you really step back and think about it, that person in that eight hour surgery with the patient on bypass with probably a $250,000 surgery, the patient in the hospital for several weeks, that heart surgery does absolutely nothing, and I mean literally nothing, to change the underlying physiology that caused that heart blockage. Zero. Right? We have another terrible thing. We say, treat him and straight em.

And straight up mean. Like, you get him, you do your procedure, you do your treatment, and then you get him out of the office, which is horrible to say, but it's one of the things we say. It's like we don't really want to deal with all the things that actually have to be done, which is, how do you address the root cause of why they're sick? How do you change their lifestyle? How do you change what they're eating?

Mark Hyman
How do you change their social network? How do you change their nutritional status? None of that becomes part of what we do. No. And then somewhere on that ward, somewhere down the hall, is a tiny little broom closet where a nutritionist is sitting, who is an afterthought in the system, who might be tailing around on the rounds, but not the hero, not the center.

Casey Means
In fact, probably in afterthought, the wimpy part of the team. That's the way nutrition is looked at. And that nutritionist, if trained properly, a functional nutritionist, has the potential to reverse the heart disease for which that patient is on the operating table. So our paradigm of who is a hero and who is a wimp is very much dictated by the financial incentives and has just clouded us. And I would sit in the workroom as a head and neck surgical trainee and bring in papers that said, hey, I think if we try this diet on this patient with sinusitis, they might do better.

We might want to get rid of some of these inflammatory things in the diet. And I was told, and I quote, really? Don't be a pussy. Wow. And that was the mantra was like, you did not come here to give nutrition advice.

Wow. So, of course, now I've embraced that, and I'm thrilled. But it's really dark what the financial incentives do to drive us to see something as heroic and something. I think you're just hitting on something. Want to unpack?

Mark Hyman
Because I don't think most people understand the nature of our system, and it's not. They're bad people. But the system itself creates perverse incentives that allow people to do and encourage people to do the wrong things or the bad things. And what's happened is that our entire, as you unpack, our entire educational system, research infrastructure, professional associations like the American Heart association, academy, nutrition, dietetics are all co opted and funded in large part by pharma and food. And it creates a very muddied waters for anybody navigating the science.

And we think science is this sort of high level, perfect, ethereal discipline where the truth is told. And once it's out there in a published, peer reviewed journal, that's the truth. And unfortunately, friends, that is not true. What's really true is that most of the system is corrupt. Most of the funding is from pharma.

Even the NIH funding doesn't fund nutrition, doesn't fund root cause analysis, doesn't fund systems thinking, doesn't fund systems approaches. And we have a very reductious model that's based on a very outdated paradigm. There's really been this corporate capture of our entire health and food care system, and it's like, the people in it, the doctors, the nurses, hardworking, good people, are in the matrix. They're in the frickin matrix, and they don't know they're in the matrix. And so it's hard for them to see outside the box.

So if you bring a paper that says, oh, here's data that shows that if you change this diet, this health problem will go away. That's not really in the paradigm. Right. So don't bother me with that piece of information, even if it's good science. And so we get really focused in a very narrow way with blinders on and only looking at data that's really promulgated and pushed by food and pharma, someone said, oh, listen, artificial sweeteners aren't so bad.

And they sent me a couple of papers. I'm like, oh, really? Okay, I'll look at the paper. I'm very interested in science. I looked at the paper, read the paper.

This is interesting. Yeah, this doesn't seem to be a problem. Oh, who funded the study? Oh, yeah. It was entirely funded by the American Beverage association, also previously known as the American Soda Pop association.

And the other study was funded by this guy who worked, was done by this guy who worked for Coca Cola and was on the board of the International Sweeteners association. So guess what? Science isn't pure and perfect. You have to be very smart. And I would say the first thing you look at is, who funded the study?

What are the conflicts of interest? And even if they're not listed, do a little homework. You might find there's another layer that you might not know about. And so it's really important when you start to look at this to understand that. And it's unfortunate for consumers out there, for people wanting to take care of their health or patients.

It's very tough to know. It's true. Casey and folks like her and what I've tried to do over my life, in my career is try to bring a sense of what. What's the wheat from the chaff? What's true, what's not true.

How do we navigate this horrible landscape that we're in? And I think good energy, your book, is just a really beautiful roadmap for people to follow to understand how we got here and how we get out of here. You know, the truth is there's good energy to be had. But right now, most people have bad energy. So let's talk about what is actually causing good energy.

How do we think about what is the root cause of the bad energy, and how do we shift that to create good energy? And that good energy isn't just like I have more energy. It's really about fundamental metabolic energy that drives our life force and is at the root of all diseases. So whether you have Parkinson's or Alzheimer's or cancer or diabetes or many, many diseases, they're often rooted in mitochondrial and energy issues, which have to do with all things you're talking about in your book. So help us sort of unpack that.

Casey Means
Yes, absolutely. So, you know, good energy is. Sorry for the diatribe on the. On the corporate capture of our food system. It's my dream.

Let's just listen to you talk about this. Everyone read food fix. The way I think about how bad energy created is created is I think about health as really like a matching problem. Our cells have basic needs. They have basic inputs that they need to function properly.

And when they get those needs met and they are not overburdened with things that they do not need, we have health. It's really that simple. Sometimes I think about these 40 trillion cells that as this whole self, we are essentially here to caretake these cells and meet their needs. And I think about them sort of as it's like we have 40 trillion little children that we're caring for, like, babies and infants. And if you think about, like, an infant, if an infant is crying, then you go through your basic checklist of what a baby might need.

It's like, are they hungry? Do they need a diaper change? Do they need to sleep? Is the temperature okay? And you run through it, because they can't speak to you.

They can only cry. And so you run through it, and then you change the environment, and they'll settle down. That's why the body has only so many ways of saying, ouch only has. Right? And with the cells, they also can't speak.

They also can't speak, and they can't cry like a baby. So what do they do? They generate symptoms, and that is what's happening, which is that our cells are not getting their basic needs met. And so they're crying out, and they're crying out through these symptoms and these diseases that are fundamentally rooted in the mitochondria not getting what it needs. And for a baby, it might be diaper change, milk, or sleep.

For the cells, it's just a basic set of things. It's what's the food that's going in? How is our stress? How is our sleep? How is our movement?

What's the toxin exposure? What's the light exposure getting? And what is the temperature around us? I think about those seven things as some of the key vectors that we can just run through in our head very simply, like, okay, how am I doing on food? Or is it getting what it needs?

Are we taking away the things that are bad? How's the movement? Are we getting enough? Are we stimulating the cells in the way they need? How's our sleep getting to?

Are we getting good consistency, quality, quantity of sleep? Just run through the checklist. And so the book has very clear sort of quizzes that you can take to really take an honest stock of the different vectors that we need to think about to see if we're meeting the needs of the cells and taking away the things that can overburden them. Because when we run through that and we do that, health emerges fairly effortlessly. So, basically, we're saying, take out the bad stuff, put in the good stuff, and your body knows what to do.

And have intense compassion for your cells. Symptoms and diseases do not arise in a vacuum. They are fundamentally and necessarily related to dysfunction in our cells. And dysfunction in our cells is necessarily caused by our cells getting too much of what they don't need or not enough of what they do need. And, of course, you've been talking about this for years, by the way.

Mark Hyman
Every doctor learns this in second year medical school. And there's a textbook we all read called the Pathologic Base of Disease by Robazon Cotran. And in that book, in the first chapter, and I reread it a number of years ago, it basically says that every disturbance, every pathological change, meaning anything you can see on a microscope, whether you can see, like, arteries or damage to the brain, every pathological change is preceded by a biochemical change. And that's biochemical changes are related to all the things you're talking about that we have influence over. And also to back up mitochondria, folks, is basically the little things in your cells that make energy.

And it's a powerhouse of ourselves. It takes food and oxygen. It combusts it and produces energy. And that's a very straightforward process. But it's screwed up by what we do and how we live.

And that's what you're really talking about is key to life. And you can, you know, you can live 30 days without food, you can live a week without water, eleven days without sleep, maybe formulas without oxygen. But if you poison your mitochondria, you're dead like that. Like you take cyanide, you're done, right? Which poisons the mitochondria.

Casey Means
Yeah, I think a lot of our health journey can actually improve if we really start to meditate on how really miraculous these, these structures in our cells are. We have, you know, tens to literally hundreds of thousands of mitochondria in different cell types, and they are the powerhouse of the cell. They convert, you know, food to energy. But if you really think about it, it is miraculous what they are doing. They are taking this cosmic energy, food energy that's literally created when the sun hits the leaves of plants.

And the sun's energy is stored in the carbon, carbon bonds of plants. And then we take up that energy into our bodies, break it down, and unleash that incredible cosmic sun energy in our mitochondria to create a currency of energy that powers us, loving, living, thinking. Wait, wait, wait, wait. We're solar powered. We're solar powered, exactly.

And so anything that we do to hurt our mitochondria, which we do through eating ultra processed food, eating refined sugars or fine grains, refined seed oils, not eating real food, by not sleeping enough, by not managing our trauma and our stress, by seeing artificial light at night, by not seeing the sunlight in the morning, by living a thermoneutral existence, by not protecting ourselves from environmental toxins, anything that we do to hurt that miraculous structure of the mitochondria? Yes. What it does is it creates insulin resistance, it creates metabolic dysfunction. But really what it's doing is blocking the unbridled flow of light energy, of cosmic energy, through our form to power our life force and our highest potential. And so it's bigger than just these clinical terms.

It's bigger than insulin resistance. It's about giving our bodies what they need to create a form that can process energy in a way that allows us to reach our highest purpose. And so it's beautiful and it's so simple. It is actually so simple to improve mitochondrial health. And I think a message I really want to get across to people is that the system depends on you thinking that it's complicated.

The system profits off you being confused about what exercise you in the medical industrial food complex? Is that what you're talking about? The influencers, the fitness industry, the healthcare industry, the food industry, they have us all running around like chickens with our heads cut off, consuming every strategy. You know, this month I've got to do resistance training. Now I've got to do yoga, now I've got to do hot yoga, now I've got to do pilates, now I've got to do keto, now I've got to do paleo, now I've got to do vegan.

Now I need this mattress. It's like, it's fascinating to just step back and realize the more research we're publishing on Pubmed about nutrition and fitness, the sicker we're getting. Well, it's not being applied. That's part of it. Yeah.

I think it's deeper than that, though. I think when you just, like you talked about with the funding of a lot of this research, there is an incentive to make it complicated when it's actually quite simple. Michael Pollan eat food. Not too much. Mostly plants.

Mark Hyman
Yeah. You know, maybe start by, like, not putting toxins all over our food. Right. Maybe we start by just, like, eating food that came out of the ground. You know, if people literally just did that, like, didn't get most 70% of their calories from a factory, we'd cut health care costs by 90%.

Casey Means
Like, it's. It's really quite. I don't. It doesn't matter if that's carnivore or vegan, if it's real unpoisoned food, we're going to be a lot healthier. And so I think the system benefits off our confusion.

And that's built into every layer of our research industry, our medical education, et cetera. And so the real empowerment is to understand that and then just blow it up and take total control in your own life. And, I mean, I think a message that I put in the book that can be scary to people is I say, don't trust doctors. Don't trust the science. Don't trust influencers, trust yourself.

Because we are living in an age where the incentives are working against us. It's an uphill battle. Last three years, we now have the tools at our disposal at home to understand more about our bodies and how our personal choices are working for our biology than we've ever had in human history. We literally can have the answers and don't need to give away our trust to other people outside of us that profit off our confusion. All you have to do is step back and look at the world and realize we're the only species with experts, and we're the only species with a chronic disease epidemic.

Mark Hyman
I love that. I would say the smartest doctor in the room is your own body. Listen to that. You know, and we have the tools now to do that, and everyone can access it. Literally, this is function health that you created, that I invested in, which allows people to go deep inside of the center of the cell and know, is it working?

Casey Means
Is it working? And if it's not, there will be clear biomarker changes that are saying that your cells are crying, your cells are the babies that are wailing, and that's a clear signal shift. Your strategy. It's not working. It doesn't need to be confusing.

It actually can be quite black and white. If I wake up in the morning and I look at my function health results, and they are pretty much all in the optimal range. And I look at my continuous glucose monitor, and I am in the very healthy, normal range with minimal glucose spikes over the past 24 hours. And I wake up and I feel incredible with no symptoms, and I feel happy, joyful, creative, and limitless. I know that my strategy is working, and that is going to be a different strategy from you and everyone else.

And so. But with that empowerment of looking at my sensors, looking at my biomarkers, and looking at my body awareness and my knowing and my symptoms, with those things, I can say with absolute certainty that I know my plan is working. No compromised research necessary. So I think there's a movement that's going to. There's actually.

Mark Hyman
We talked about this before on the podcast. But the highest level of evidence, according to the National Institute of Health, is n of one studies, meaning you're your own control. You do something, you change something, you see what happens. I had a patient who used a continuous glucose monitor and you created levels that really allows people to be democratizing their own biomarkers in real time by having a monitor that you stick on your skin that tracks your blood sugar over time and you get instant feedback about what's happening. And, you know, most of the time it's the obvious stuff, right?

It's, you know, what we're eating, it's not exercising. But what was really interesting with this patient, I had just talked to him on Saturday. Basically, he has been involved in optimizing his health for a long time, but his sugar was still dysregulated. Exercise is great, eats great, doesn't do anything bad, doesn't drink. And what we decided was he probably had some level of toxins, which we now know are another factor that drive insulin resistance.

So it's not only what we eat, it's petrochemicals, plastic, phthalates, PCB's, BPA, heavy metals, all these things. Arsenic. All this we know is linked to diabetes. This is in the literature. But of course, if you go to endocrinologist, they're not talking about this.

But we put him on a cellular detoxification regimen and hes like, man, my sugars for the first time are actually normal. This is amazing. And I was like, wow, thats really interesting feedback. So now were able to get feedback in real time about whats happening in our body. So you could say, well, wheres a randomized controlled trial that environmental toxins, if you detoxify someone using this protocol actually fixes their blood sugar and regulates that, you might not find it.

And this is what happens in medicine. There's this discrediting of anything that doesn't fit the orthodoxy with this rubric of evidence based medicine which essentially says that if it doesn't meet the standard of the highest level of evidence, which is a randomized, controlled human trial, then there's no evidence for it. That ignores an entire set of other types of evidence. Basic science evidence, animal studies, smaller clinical trials, population studies, cohort studies. There's a lot of evidence.

And we have to sort of read the tea leaves. It's not like black and white. So anything that doesn't fit the orthodoxy gets discredited. And the way research has done is only to drive these large trials for pharma. So you're not getting trials on cellular detox protocols for diabetes.

You're not getting trials on big trials on nutrition for diabetes. Right. You're getting a little bit here and there, but it's not really building the evidence base that conventional orthodoxy says has to meet that standard in order to actually believe it or do it. And so what it means is it's a way of discrediting anything that that people don't want to include in their framework or that doesn't fit this medical, industrial food complex. Yes.

Casey Means
What you just brought up is a perfect example of how we are so blinded to the influence of some of these industry forces on something as foundational as our research. And the hierarchy of evidence at the top of that pyramid is double blind, placebo controlled, randomized studies. And baked into that, the fact that you'd have a placebo and an intervention is that it must be a pharmaceutical cause. Obviously, if you're doing exercise or a dietary intervention, you can't have a placebo. You know, what you're doing.

So, baked in to our hierarchy of evidence is a bent towards medication intervention, 100%. And this is where, of course, n of one studies where you're just looking at your interventions, your complex, interdependent suite of choices that you're making and how they're affecting your core biology. And we can look at that with these incredible tools and technology that we have today, coupled with slowing down and making the time in our lives to hear the signals from the body in the form of symptoms, intuition, and body awareness. So those, essentially, that's what your book is about. It's empowering people with the knowledge, the data, the information to actually do this for themselves.

Mark Hyman
You know, and I think you and I both believe in democratizing healthcare, democratizing what we do. Getting out of the guild of medicine, where everything is protected by healthcare systems and doctors, and you can only get your health data from them, and you have to ask for it. You have to beg for it. And maybe they won't do it, or maybe they will do it, or maybe they'll do a little bit, but not all, but you want or not even what actually should be done, because they might not know about it. I asked the head of quest labs, how many of your lab tests include, you know, insulin?

It's, like, less than 1%. Yeah. You know how many include lipoprotein fractionation? Less than 1%. But these are things that are the most essential things you need to know, and we're completely blind to it.

So your book is just so good in that way that helps us think about this and empower people. So what are the. What are the principles for good energy and for how we eat. And what do we, what do we do with the information that you've learned in researching all this data? I mean, you're like Stanford trained doctor, super smart.

You've dug into this, you've kind of tried to sort through what's true, what's not true. What did you come up with as the principles of good energy, and how do we do that for ourselves? Well, I think one thing that every single person can do, literally, today, as they're listening to this podcast, is they can go back to their health record from their last annual physical and find out if they are making good energy or bad energy. And it's very simple. There are five key biomarkers that can give us a sense of where we are on that spectrum.

Casey Means
And so those five biomarkers, to understand if you have good energy or bad energy, are fasting glucose biomarkers, like a. Blood test or any kind of thing that tells you anything about your body. Right. It could be your wearable, it could be blood tests, it could be urine. So these are things we have to know.

Mark Hyman
So what are the biomarkers? Yeah. And, you know, you can go down the rabbit hole of getting very complex about these things. But again, I really want to bring forward this idea that it can actually be quite simple and quite inexpensive. And so, five of the signals from your body that there may be bad energy brewing are your levels of fasting glucose, triglycerides, hdl cholesterol, blood pressure and waist circumference.

Casey Means
So if you look and you mentioned insulin, these are the five biomarkers of. Simple biomarkers of metabolic syndrome. Absolutely. We can go so many layers deeper with insulin, and we talk about that in the book, but just foundational, like cheap, pretty much free, and probably on your last physical would be those biomarkers, fasting glucose, triglycerides, hdl blood pressure and waist circumference and triglycerides, you said? Yeah, triglycerides.

Yeah. Fasting glucose, hdl, triglycerides, waist circumference and blood pressure. And so if you look at those which are probably on your, your panel from last year, and if your fasting glucose is under 100, triglycerides under 150, hdl above 40 for men, above 50 for women, waist circumference less than 35 inches for women, less than 40 inches for men, and blood pressure less than 130 over 85. If all of those are true, and you are not on medication for any of those, then you are part of that. 6.8% of american adults who are categorized as, quote, unquote metabolically healthy, aka making good energy.

So that's just the first place to start, is look at those five pretty much free biomarkers and see where you are. So if triglycerides are above 150, if fasting glucose is above 100, if blood pressure is above 130 over 85, if you're a woman and your waist circumference is above 35 inches, or hdl is lower than 50, you need to start looking at what's going on in your cells, because even though they're pretty simple biomarkers, what they're each saying is something about what's happening on the inside of the cell. But as doctors, we're not actually even trained to think about how these biomarkers relate to internal cellular physiology. We just look at them in an algorithmic way. Does a drug treat this way or that one?

If fasting glucose up, give metformin or insulin? If the triglycerides are high, we don't even know what to do that with that, because there's not a drug. If the waist circumference is high, we need to give ozempic. But if you think deeper, to really the core of this mitochondrial paradigm, you can actually know more than probably your doctor knows. Let's think about it for a second.

If your mitochondria, this powerhouse that converts energy, food energy, the literally the 70 metric tons of food we take in our body in a lifetime to convert to cellular energy, if that mitochondria is broken because of all the things we talked about, the food, the exercise, the sleep, the stress, the toxins, the artificial light, the lack of temperature swings, these vectors that we can talk to our mitochondria with, if they're broken because of all these issues, sleep deprivation, sedentary behavior, overabundance of toxins, if the mitochondria is broken, it's not going to be able to convert that food energy to cellular energy. And so the cell is going to say, we can't do it. We don't have the capacity, because I'm broken from this modern world that we're living in, and it's going to protect itself by blocking the cell from taking in more food energy, that is, glucose, into the cell to convert to energy, because it can't process it. So now the body creates insulin resistance. And of course, insulin resistance is the body essentially making the cell impenetrable to glucose by blocking the insulin receptor from working.

Insulin is, of course, the hormone that binds the cell and lets glucose in. So now you have insulin resistance, essentially as a protective mechanism. And so what will happen is the body, the glucose, will rise in the bloodstream because it's not able to come into the cell because the mitochondria is fundamentally broken. So how does this show up on these basic biomarkers? Well, our fasting glucose goes up, and then also our triglycerides go up because the body doesn't know what to do with all that extra glucose floating around in the bloodstream.

So one of the things that's. Right, from the triglycerides, right? Yeah, exactly. And it'll convert a lot of that glucose to triglycerides. So through this framework of mitochondrial function and the overburdening of the mitochondria, we start to see these basic clinical biomarkers of metabolic syndrome and really understand what they're actually saying about the inside of the cell.

And what they're saying is that the mitochondria is suffering. So that's just five basic biomarkers that you can look at. And then the next level is to go deeper into other biomarkers that can give you even more nuance. So this is things like the fasting insulin and the high sensitivity crp and the liver inflammation. Yes, liver function tests and essentially these other lab tests that tell us what arises in the body when that mitochondria is dysfunctional and so uric acid.

And so in the book, we talk about this higher level of tests. And, of course, those are the tests that your doctor probably isn't going to. Order for you include in the function health basic panel for $4.99. Then you go to functionhealth.com, comma mark, jump right in past the wait list, and you can get all this data. And what's really important, and I just want to emphasize something.

Mark Hyman
The numbers you quoted for those five biomarkers are numbers that are accepted by traditional medicine as the threshold for when you kind of cross over into prediabetes. But the truth is that those numbers are not optimal in any way. Like your blood, your triglyceride should not be 150. It should be in the seventies. Your blood sugar shouldn't be 100.

It should be in the eighties. Right. Your blood pressure shouldn't be 130 over 80. It should be like 110 over 70. Right?

Right. Your waist circumference shouldn't be 35. It should be like 32 or 33 or 34, depending on how big you are. But, and so all these numbers that are, that we think of as sort of the threshold are really, you're already way down the road. And so, so I think by the time your blood sugar starts going up, this can be going on for decades.

The insulin resistance and the insulin that you mentioned is a better way to test for it. So you really need to do the right tests. And that's really why we've created function health. That's why you create levels to help people actually see what's going on inside their bodies. Yeah.

Casey Means
And I actually believe that every single person listening to this absolutely has the capability to understand their key metabolic biomarkers and interpret them and understand what the tea leaves are saying. And I not only think that they are able to, I think it's that it's imperative that they do, because medical school is not changing in the next 510 15 years, unfortunately. I would hope so. Daughters in it. Now, doctors are not learning how to read the tea leaves, so you have to, and I absolutely believe that everyone.

Can you make it simple? I make it simple in this book. Sit down with a printout of your lab tests, with the book, with your articles and books, and figure. Figure it out. And I think there's such a infantilizing perspective within the healthcare system of patients not able to understand this or even to go as far to say, it is dangerous for patients to have this information because what are they going to do with it, you know?

And I think that that is something I really want to debunk. Yeah. We were trained to never give people their lab results. Just tell them everything's fine, your panel is fine, your cholesterol is fine, your blood chemistry's fine. They might freak out.

They might freak out. And it's like when you actually wake up from the matrix and realize, oh, my God, that perspective was put into me of not trusting patients, thinking patients are non compliant and can't handle their data. They're not educated enough to understand their data. That's part of very paternal system to drive, essentially to drive not only the industry, but to truly get us to be divorced from our common sense so that we put our trust outside of us and feed into this huge industry. And a big call to action and good energy is to actually reclaim our internal power and our internal knowing of what's right for us in our body.

Couple that with tools and technology and use your, you know, find good doctors and use your doctors as a counselor and a coach, and, of course, use the healthcare system for acute issues. Of course. Yeah. But for the chronic issues, we really do need to be the CEO of our own health, as so many people have said. And that's a key message of actually realizing that the infantilization of patients is part of the whole game.

Mark Hyman
Yeah, it's true. I think that's really why you created levels, why we created function. Health was to empower people with their own health data. Yes. And to make them the center of their health and the seal of their health and not the healthcare system, and take back your health from the healthcare system.

I mean, actually, I created a bill in Congress with Mike Royce and a few others years ago called the take back your health act of 2009. During Obamacare, it never made it into the law, but it was basically about empowering people to actually change their lifestyle, change their behavior, and take back their health. So going back to those six principles, let's go kind of through them a little bit, because I think they're quite good. The first one you sort of talked about was how food determines the structure of our cells and our microbiome. So just give us a little unpacking of that.

Casey Means
Yeah. So in my chapters in the book about how to eat, it's really saying, like, we need to stop with the dietary dogma, we need to stop with the food wars, and we need to focus on principles of eating. And the first principle. So I wrote the piegan diet for. Exactly.

Mark Hyman
Making a joke between paleo and vegan. And I'm like, yeah, yeah, think first principles. Like food. You. This is a quote from Mark Hyman.

Casey Means
But food is molecular information. And when we see food as molecular information, it becomes so much simpler to say, okay, there's lots of different ways I can get the proper molecular information for my body. My job is to get that information to the body. But there's a lot of different ways that you can do it. All of them are thoughtful, and all of them need to be based in real whole foods, but there's many different ways to do it.

So the first principle I talk about in the book is that food determines really the structure and function of our bodies. And so from a structural perspective, just think about the cell membrane. The cell membrane is made of fatty acids that come from our diet, and we want there to be a healthy ratio of omega three fats to omega six fats. And that is totally determined by what we put in our mouth. In just a few days, we can change the composition of our cell membranes by what we're actually putting in our mouths, and then that has a huge trickle down effect for how our cells fundamentally function and how our immune system functions.

Because a lot of the inflammatory mediators our immune system makes are actually done by snipping fatty acids off our cell membranes and turning them into inflammatory chemicals. And so based on what that ratio is that you're eating, you'll change the structure of the cells, which then changes the function of the cells. Similarly, if you think about neutrogenomics, which I think is probably one of the coolest things in all of healthcare, you realize that this gene, we have this idea that genes are our destiny. But then when you learn about neutrogenomics, you realize every single bite of food you take into your mouth are actually these little pieces of information that change our gene expression, not only our gene folding, but which genes are actually expressed and how much and when. It's absolutely incredible.

So I talk about things like curcumin and things like isothiocyanates and these chemicals. Those are from broccoli. In other words, cruciferous vegetables. Where am I going to find that in the grocery store? Cauliflower, bok choy, arugula.

Just literally google cruciferous vegetables and eat them and it's going to change your gene expression of your antioxidant genes. Eat the curcumin from the turmeric and the curry and that's going to change your expression of inflammatory genes. And so food is the structural and functional information that we put into the body. And if you really just know some basic concepts about what the information your cells need, you can choose to eat properly. And that feeds into the five elements of good energy eating that I tell people to just, just learn these and learn what the sources of these are and put them on your plate.

And I talk about how the information for structure and function that your body needs comes from fiber, antioxidants, healthy protein, omega three fats and probiotic sources. And if you can learn basically your favorite foods in each of those categories and just craft your meals based on those principles, which can come from any dietary pattern, you are going to give yourselves the building blocks and the information to have good structure. It's not that hard to learn, you know, like you just have to do a little homework, read the book, look at what Casey's done. And when you go to the grocery store, think of it as your pharmacy. So when I go to the grocery store, I'm like looking, I'm hunting, like hunting and gathering.

Mark Hyman
I'm hunting for the medicine. When I think of it as my pharmacy, like with an f, but still, even, not even with an f, it could be ph, you know? And I think those drugs in the good drugs, good modulators of our biology that are in the grocery store, we need to understand what they are and where to go for them. So I'm always going for the cruciferous. I'm going for the shiitake mushrooms.

I'm going for the phytochemical rich berries. I'm going for the omega three rich sardines. I'm going. I'm going for the olive oil with the oleurpene. This is an antioxidant.

I know what to choose because. And the rest of the stuff just kind of fades into the background, you know? And I think if you just learn a little bit about these things, you can really be your own advocate and navigate how to do the right thing, because we just don't learn that. We don't know. And I think, you know, what Casey's talking about is not just abstract.

Oh, your cells aren't great, and you need to make your cells better. But we both had surgery training. I mean, you're an actual surgeon. I was just a family doctor who did some surgery on the side, but I did assist in a lot of surgeries. And I remember these patients would come in who are super unhealthy, overweight, really metabolically unhealthy, and we would try to operate them on them, and their tissues would, like, fall apart in your hand, and you try to sew them together and the tissues wouldn't stick.

It's literally their cells were not functioning inside. And when you saw that, it was, like, really shocking. You know, we even had a terrible name for it. PPP. Remember what that is?

Casey Means
Oh, no. Piss poor protoplasm. You heard that dark. Yeah. Protoplasm is like, what you're made of, right?

Mark Hyman
So it's like, it's just really bad tissues. And it was a thing in medicine that we never talked about. We never really understood, we never thought about. It's like, oh, this person has that. But it really affected ability to just surgically repair some.

Casey Means
Yes. Oh, I saw that. I remember saying to my family once after a day of surgery, I said, but the number one motivator at this moment in my life for me to be healthy is that if I ever have to have an emergency surgery, I don't want to be a body that is so malfunctional that when the person has to operate on me, I'm making it more difficult for them. Because you go in and we were working in the neck and people who had so much extra fat, it's like you're digging through the fat for the nerves. And these are nerves that control every aspect of your facial motion and your voice.

And it makes it so much harder to even see the nerves if it's surrounded by inches and inches of fat. Similarly, if the patient is really unhealthy, the tissues almost fall apart under your forceps. And so it's much difficult to stitch things. So I'm with you. It's like if you really see the tissues up close and personal.

But of course, this is happening on the surface of our bodies, you need to have surgery to know this. You can look at someone and look at their skin and how healthy it is, and that can be such a signal of what's happening under the surface. And all of this is a reason why I talk in the book about how so much of this actually also comes down to the food quality that you buy. Because if you really, really internalize that food is the building block and the molecular information of how your body will function, of course you are going to invest in higher quality food, but you have to believe it, and you really need to internalize it. So I think one of the quickest ways that people can move towards health is to just buy more of their food from the farmer's market.

Because we take in 70 metric tons of food matter into our bodies in our lifetime, and that's constantly turning into and 3d printing the next version of our body. Literally 3d printing. And if we, you know, because our soil is so depleted, coupled with the fact that we are processing all our food, we are literally just the micronutrients and the antioxidants, and this information is literally falling out of the food because the soil's poor and we're processing it. So the closer you can get to food that is from good soil, so it's enriched with more nutrients and unprocessed, more of that 70 metric tons of information that you're both building yourself from and that is dictating the function of your body, will be helpful material. Right now, it's not only empty, it's harmful.

Mark Hyman
Well, I think Michael Pollan's how to eat food, right? What does that mean? Well, what is food? And I talked about this in other podcasts, but the definition of food, if you literally go to the dictionary and look it up, it's something that maintains life or growth. So if it's not doing that, it's not food.

So if it's some processed junk, if it's cheetos, doritos, or things that even resemble real food, that aren't real food, even like the impossible burger, which is a science project that's made from weird gmo soy stuff that I wouldn't touch that. That's not food. It doesn't maintain life or growth. And I think we have to be really straight with ourselves. Like, what am I doing?

This is. Would I put, like, you know, water in my gas tank? Would I put dirty gasoline in? What? I.

I mean, it's not. Your car's not gonna run. I had someone do that. I lent my car in residency to a friend of mine. It was a diesel car, and he put gasoline in it, and the thing wouldn't go, and it ruined the car.

And so, like, that's what we're doing. We're putting the wrong fuel in. And what you're talking about with good energy is, how do we fuel ourselves? How do we fuel ourselves as the answer to not only our own well being, but to our collective social and economic well being as a society? Another sort of piece about the body, like a framework that I really think about all the time, is like, our cells are blind.

Casey Means
They don't have eyes, and they don't have arms, right? They just are cells with little receptors. And so they're in the dark, and they're all this stuff is just floating around. And what's floating around is determined by what we're eating. And so let's say a cell wants to make a selenoprotein, like glutathione, an antioxidant or a protein that's going to be a critical factor of our immune response.

And it requires zinc or selenium to actually build that protein. Well, you get to determine whether that that cell is going to be able to reach out and grab that micronutrient to build that protein or that amino acid based on what you're putting in your mouth. So you need to load the body with the highest quality food possible, unprocessed from good soil, because you are going to increase the probability that those little cells are going to have the right thing floating around them to do what you want to do, which is be healthy and not be sick, and to have the support to free up the mitochondrial function so it can process that energy and power your life. Because fundamentally, our life and everything we're experiencing is just the bubbling up of the trillions of chemical reactions that are happening every second. And how we view food is such a big piece of that.

And it's another piece of the connection conversation, because I think a second, kind of going back to the beginning, it's like a second piece of connection that we've so lost is this idea that we're connected to everything else in the environment. We are connected. This body to the soil, to the air, to the food, to the water, to the sunlight. All of these material and energetic forces are in constant conversation with our bodies. And there's this fascinating statement that I love from the taoist philosophy.

That's this idea that we need to look at the human body for what it is, which is a process, not an entity. And we have been entrenched in this system of thinking of the body as a thing that is separate from everything else. We are a body that lives and dies. I'm a body. You're a body.

Mark Hyman
What America was found on was individualism. Individualism and not mutualism. Not mutualism. And because of that, it has entrenched a view that that sunlight and that artificial light from the computer and the food and the water and the air and the soil are all separate from us, rather than the true reality, which is that we are this swarm, this buzzing hive of material, of atoms, that's constantly exchanging matter and energy with everything around us. It is all us.

Casey Means
And because of that individualistic, sort of very western mindset, we actually. It allows us to trash the environment and not really understand how that's what that's going to do to us. It allows us to totally kill the soil with industrial agriculture and pesticides and not realize that we're just poisoning ourselves because it's all the same thing. So there's an element of the book where I really ask people to internalize and meditate on our true nature, which, if we had a microscope that could actually see what our bodies really are and see how we are just these swarms of material, we would get that. But because of the limitation of our visual system, we think of ourselves as these separate things.

And I'll never forget, in medical school, in histology class, it was really one of the most impactful classes for me, because, you know, you take these. Histology is basically the study of the cells. You learn all about the different kinds of cells in the body. Yeah, well, you cut the body up, and you look at the tissue under the microscope. Mind blowing.

Yeah. And so you're like, okay, here's skin. But really, what is skin? Skin is these. Your little teeny thin piece of tissue is tens of thousands of individual cells that are actually in all stages of life.

Some are being born, some are dying, some are replicating. So this idea that we're a thing and we're alive and we're separate, it's all false. And until we get back to that true understanding of our true nature and of that interconnection. We will continue to build the healthcare system on a false premise, on a false God of individualism and separation that dictates every aspect of what we do and points us in the wrong direction. So you're talking about in your book a lot of things.

Mark Hyman
I mean, you cover so, so many things that have to do with not just food, but exercise and dealing with your environment, circadian rhythms. You have a four week plan. It's really very robust, and I think it's almost like a. A Bible for health and takes you from a to z. So we couldn't cover all of it during this podcast, but I encourage you to really get this book.

It's good energy. The surprising connection between metabolism and limitless health. It's by Casey and her brother Callie, who's also been on the doctor's pharmacy podcast. And I think it's going to make a big, big impact. I want to just close by, you know, zooming out, because a lot of things we talked about were the forces that are driving us to have bad energy and that are preventing us from having good energy.

In other words, from being healthy and vibrant and having our metabolic health great and our mitochondria great. And there's things we can do about it. And a lot of these things have to do with more social, political issues that are kind of a little out of people's reach. But I think it's important to touch on them. And I wrote a book called A Food Fix, and we talked about some of the policy issues, that some of these can be done with executive orders.

They can fix things tomorrow, sort of kind of run through a few of the ideas that you think are going to be the most impactful. Because I think people need to understand that. They need to be advocates when they're at the voting booth, when they're voting for their congressman or senator or president. They need to think about what do they stand for on these issues? What are they doing about this?

Casey Means
I mean, first of all, no one in, I think the world has brought this more to the forefront than you and Callie and I are truly just like foot soldiers in this mission. And, you know, but I think when we really step back and think, like, what would make a big difference tomorrow if this changed in our culture, one is we need to not have the pharmaceutical industry controlling our media. And the way that happens is by the pharmaceutical industry essentially paying for 60% of all advertising on mainstream media. I think what who spends the other 40%. Right.

I mean, just mostly processed food. Yeah, exactly. Watch the Super bowl. There are eleven commercials for junk food. In the first half.

Mark Hyman
I didn't watch second half. I just got so disgusted. Yeah. It's hard to watch and watch that revolving door. And I think something that people need to internalize is that you are not the customer of the news network.

Casey Means
The pharmaceutical industry is the customer of the food network. Because who's paying the bills? It's not you who's watching it for free. The ads. Right.

It's the ads. And so what does that do? It changes the core information that we're getting that we think of as journalism and truth. Yeah. It's not.

Yeah.

You got your hand in your head. No, because I've been involved and been on television so many times, and I just know how it works on the back end and how you can't say certain things you can't talk about, certain things you can't discuss. I mean, my stark example is, was on the, I think it was Today show, and I did a great segment with Al Roker and it was like a great thing. And I met the producer and then I said, hey, I got a great idea for another segment. She's like, what?

Mark Hyman
And I'm like, well, how about we do this 100 calorie comparison of 100 calories of the snack packs of Oreos or whatever, m and m, whatever it is, and compare that to 100 calories of blueberries or almonds. And let's talk about this sort of difference that these have on, on your body. What are the impact of these different foods as food, as medicine? She said, great idea. So we did this thing.

We got it all set up. I think she kind of didn't ask for higher ups. And the talent came on and literally wanted to sidetrack the entire conversation because it was basically showing that all this processed food wasn't good. And I was talking about the deep science of how the molecules in the real food were working on the body and how the molecules and things that weren't really food were affecting the body. And it was a little bit challenging.

And I never got asked back on the Today show. Wow, Mark. I mean, that's so telling. That's a perfect example, I think, of what we're talking about. And so the basic place that we're getting our information is deeply influenced by a force that wants us to be chronically ill so that we can be customers of the pharmaceutical industry.

Casey Means
So that's number one. I think number two is so basic, which is we've got to change the farm bills to incentivize the production of non toxic, real nutrient dense food rather than toxin covered commodity crops that get turned into processed food. So we are literally, we're working on that. How to incentivize regenerative agricultural. And I mean, I will, if it's okay, I will literally quote you on your own podcast because I think it's one of the most important points that I think we just have to realize because so much of the conversation about healthy food comes back to like, that's elitist and it's only for, for wealthy people.

But every person paying a taxpayer dollar in America, this matters. For if you are buying processed food in the United States, you are paying for that food at least four times over. You are paying for the food in the store, you are paying for the farm bill subsidies that made that food cheaper, that unhealthy food cheaper. You are paying for the environmental damage of what that the way that food was grown is doing to our water, air and soil. And you are paying the health care dollars, taxpayer money for the health ramifications and the chronic disease of that food, Medicare.

And Medicare is $100 whether you like it or not. And we are the voters. We are the consumers. It's no one's responsibility but ours. And the first way that you can do that is invest your money in buying real food from sustainably growing farmers, farmers markets and making sure that you understand who your representatives are and getting in their face through letters, emails, going to their office and telling them what you care about.

Because Callie and you have been in front of Congress have talked to these people and they've got a million issues on their plate. They're not bad people, just like the doctors. But the person who's in their office every single day lobbying is the person that they're going to get the most information from. And right now that is the food industry, who spends more on lobbying than any other industry, healthcare and food, than oil. So the farm bills, we need to understand how much of a root cause of our sickness right now is the fact that we are making the unhealthy food cheaper through taxpayer dollars and refuse to allow that to happen because we are literally the citizens who can do that.

So that's the second one. I think a third one is get the added sugar out of this national school lunch program. It's ridiculous that we're serving children added sugar in schools. This is criminal. Literally criminal.

Mark Hyman
No biological requirement. And it's. Yeah, it's crazy. We need to get the money out of the FDA, the USDA and the NIH, these federally funded organizations, a huge part of their budget is coming from the pharmaceutical industry and food industry. That's crazy.

Casey Means
You know, these institutions should be representing the individuals, not the interests of the corporation. So if you're academic institution, academic institution, if you are accepting federal dollars, which would be, of course, academic institutions, NIH, FDA, USDA, no conflicts of interest with food industry on the advisory boards, and no money from these industries. Because, of course, you know, when 95% of the people who made the USDA food guidelines for America have a conflict of interest with the processed food industry, which is what it was, of course there's going to be more leniency towards those foods. And the most egregious thing happened in the last food guidelines determination for the 2020 to 2025 dietary guidelines for America. Dietary guidelines for America the scientific advisory board for the guidelines recommended that we decrease the percent of added sugar as total calories in the american diet from 10% to 6%.

And the guidelines, the people who finalized the guidelines rejected the scientific advisory board's recommendation. And so we got to get the money out. It used to be the scientists that actually made the final determination. But under President George W. Bush, that was changed and it became a political decision.

Mark Hyman
And now it's politicians who make the decision. It's very bad. It's very bad. The one thing that occurred to me, though, and this could be a really interesting framework for thinking about this, if we actually did the right research, and it's a little bit of a chicken thing, if we did the right research on nutrition and lifestyle and all these things we know work and we actually funded that properly from the government, it would save us trillions of dollars in healthcare costs because the government pays in some way or another for about half of all healthcare costs in America. And so you're talking a couple of trillion dollars, what if we took some of that savings, we pocketed and paid down the debt, and what if we took some of that savings and we invested it in research where the government's funding large trials and basic science and other studies?

Looking at this from a really dispassionate view and trying to get to the answers, because I think if we were able to do that, and we got pharma out, and we got the food industry out, and we stopped funding all of our research infrastructure through industry, we maybe, maybe get you some of the answers. And I mean, I think that is very important. But just as important is to, I think also to realize that I don't think we're gonna research our way to the answer again. It's like no other animal in the entire world has a chronic disease epidemic. I think a lot of it's actually, like, kind of getting away from the cult of.

Casey Means
We need evidence. And, I mean, I'm sure people will balk and say, like, oh, my gosh, this is not evidence based medicine, but evidence based medicine is broken. It's corrupted. And so I'm not actually saying that. Cause I'm saying you should absolutely verify what's going on in your own body with data, for sure.

Mark Hyman
Yeah. And a lot of good energy is all backed up by scientific evidence and research, and it's good for you, but. A lot of molecular biology research, and it's when we start to get into the, like, the nutrition interventional research, that things get really hairy. And I think that we know enough right now in the science to know that nutrient dense, non toxic, non pesticide covered, whole food, unprocessed diets are better for health. So if I think about, like, what if we could take 2 trillion of those dollars and literally just give people healthier food, which has been done, you know, or promote, put it towards the school lunch program, real food.

Casey Means
And so I think it's gonna be.

But bottom line is, we have to be eyes open in this. And I think right now, a lot of people aren't even aware of the issues. That's why, of course, we have these conversations. Casey, you are just an incredible spokesperson for the future, where we all need to be going for how we need to rethink healthcare, rethink our own health, and rethink all our food policies. So you just are a tutor force, and the book is a tutor force.

Mark Hyman
Everybody needs to get a copy. Good energy. It's out now. You can go find it anywhere you get your books. It's called the surprising connection between metabolism, limitless health.

Casey Means
And they can find you where I'm at caseymeans.com. The book is everywhere books are sold. I'm on Instagram at Dr. Casey's kitchen and everywhere else, all the other social media channels. I'm Casey means Md.

So. And then levelshealthislevelshealth.com. And that's, of course, how you can get continuous glucose monitors to really understand your own metabolic health and be empowered to know how your diet and lifestyle is affecting you. Amazing. And we'll put all those links in the show notes.

Mark Hyman
Get the book. You won't be sorry. Casey, thank you so much for writing it for all of us. Thank you for the world. It's a gift.

Casey Means
Thank you Mark. You know you are my hero and my inspiration.

Mark Hyman
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