How Diet, Lifestyle Could End 80 Percent of Diabetes, Cancer, Other Disease | CLIP | Vital Signs

What if it were possible to eliminate most of society's chronic disease, like cancer, diabetes, heart disease, through basic changes to the way we live? My guest today, Dr. David L. Katz, believes that it is possible, and he has the research to back it up. Dr. Katz has specialized in internal medicine, preventive medicine, and public health, and in lifestyle medicine, and he has a particular expertise in nutrition, which is what we'll focus on today. Based on the world's healthiest people, what are the essential elements of a healthy diet? We'll probe these and other questions today. Welcome to Vital Signs, Dr. Katz. So great to have you on. Thank you very much, Brendan. Great to be with you. Really looking forward to getting your insights on what we can eat for better health, and I'm particularly pleased that you're staying on for this live Q&A that's going to start at 2 p.m. Viewers, at 2 o'clock, we'll have a live Q&A session with Dr. Katz, so if you have a question you'd like answered, you can submit it by clicking on the yellow bar just below the screen. If you're watching on a social media platform, you can join us on the Epoch Health platform to submit your questions directly. Just look for the link that will take you to the Epoch Times website in the description. Okay, let's get started. Dr. Katz, you've said that virtually 80% of society's chronic disease could be eliminated. In a nutshell, how could that be achieved? Well, first thing, Brendan, it's important, as you said at the start, to have evidence behind this, so this is not just my opinion. In fact, the evidence on this very topic changed the entire arc of my career, because I finished my training in internal medicine in 1991, went immediately into a second residency in preventive medicine and public health at Yale, and I completed that in 1993. And within weeks to at most a couple of months of my completion of that second residency, a research paper came out in the Journal of the American Medical Association entitled Actual Causes of Death in the United States. Provocative title, right? It certainly caught my attention, and I'll spare you and listeners the ways that it changed my career, but it gets right at this question. What do we need to do to eliminate 80% of chronic disease and premature death in the world around us? What do we need to do to reduce our personal risk of premature death from almost any cause of chronic disease by 80%? Well, this paper began to answer that question, because when they looked for the actual causes of death, they were talking about the root causes. So, for example, if someone dies in the hospital of heart failure secondary to heart attack, that may be all the information that's listed on a death certificate, but it leaves you wanting to know what caused the heart attack. And if the answer to that is atherosclerosis of the coronary arteries, then it leaves you wanting to know, well, but what caused the atherosclerosis to form in the first place? So that's what these authors did. They dug down to get at these root causes. And when they were done, they had enumerated a list of 10 factors, which altogether explained almost all of the premature deaths that occur in the country every year and most of the chronic disease. What grabbed my attention as a newly minted preventive medicine specialist with a particular interest in nutrition and lifestyle was the first three factors all by themselves accounted for 80% of the burden. There's that figure we're talking about. 80% of premature death, 80% of chronic disease were attributable to tobacco, poor diet, and lack of physical activity. I've called them bad use of feet, forks, and fingers. So 80% of the risk for premature death and chronic disease. And there is an abundant literature ever since that has looked at this from both sides. So what happens if you have risk factors, if you smoke, if you eat badly, if you're inactive, but what also happens on the flip side of that coin, if you get it right, what if you don't smoke, you eat optimally real food, mostly plants, and we'll obviously spend some time getting into that formula and are physically active on a regular basis. And the answer is over any period of time that's been studied, your risk of developing any major chronic disease relative to the population at large goes down roughly 80%. Before we leave this topic, I know we've got lots of ground to cover. I just want to make sure everybody listening feels this. One of the problems with public health, and I say this as a public health physician who's devoted my career to this space, is that the public is a fiction. There is no public. There's you, there's me, there's everybody else. There are families, the people we're connected to, people we love. The public is an anonymous mass that doesn't really exist. Like an abstraction. Exactly. Yeah. I mean, basically behind the veil of the public is lots of real people. But because of the veil, it's a statistical anonymous mass that doesn't make us feel anything. And that's a real problem because when we improve public health, it transforms lives, lives of people we love, lives that change the way our own lives feel, and maybe changes our own lives directly. So it's really important to part the veil of statistical anonymity and make sure that when we talk about massive improvements in public health, 80% less premature death and chronic disease, we all appreciate what that would feel like. So everybody watching this, think about people you love and think about whether someone you love has been affected by heart disease or cancer or stroke or diabetes or dementia. And think about the challenges of dealing with that. Think about how harsh it was to get that news. And now imagine a world where eight times in 10, that news never came, that bad day never happened. You never got the call about the trip to the hospital or the ICU or the emergency room or the doctor, never got the bad test result because so much of it has gone away. We're really talking about a tremendous addition of years to life and life to years that makes our experience richer and better and protects the people we love. So it's that simple. Frankly, avoid tobacco, eat opaline, be physically active. There are other things we can get into as well that complete the formula. You mentioned avoiding tobacco, eating well, doing exercise. I imagine there's a few other there as well. What would diet represent of that? How important is diet in that scheme of things? Yeah. So when this paper came out in 1993, it was number two on the list of causal factors. Tobacco was number one. Poor diet was the second leading cause of premature death, in the years since, it has become number one. Diet quality measured objectively is today the single leading predictor variable for premature death and chronic disease in the modern world. So this would be true in all industrialized countries. Number one. That is staggering to hear. It is. I know you refer to it as the blood pressure cuff of this period of time for its significance as a vital sign in determining what our risk of disease is. I know that your focus is very much on health and lifestyle, on diet and lifestyle, Dr. Katz. What about DNA? How much does a person's, the factors that are out of control for a person, what they're born with, how much does that factor in to a person's health? Important, obviously, but DNA is not destiny. And dinner to a much greater extent is. So there's the very occasional, very rare disease where a specific genetic mutation actually causes the disease. Most people probably have heard of Huntington's disease. It's a genetically dominant disease where a mutation means you're going to get the disease. And it's a tragic condition. It shortens lifespan. It's on a very, very short list. And that's why everybody's heard of Huntington's disease, because it's basically an exception that we trot out to help establish the rule that most of the time DNA is not destiny. And there are good reasons for that, Brendan. 95% of our chromosomal real estate is not genes. 95% of our chromosomal real estate is what's called the epigenome. It's the spaces around genes. And those spaces are populated by what we might think of as molecular levers and switches that dictate what the genes do. And studies show that even people with very high genetic risk for a given condition can change their outcome, can change whether or not they get that condition. Let's take heart disease as an example, by behaviors that reset the levers and switches of the epigenome. So that's called epigenetics. So we can't change the genes we have, but we absolutely can change what the genes we have do. And the single leading determinant of what our genes do is what we do. Lifestyle behaviors can massively alter the settings of the epigenome. And what this results in is you could have genes that do, if you will, bad things, increase your risk, say for heart disease or heart attack. You can turn those genes off. So whatever they were contributing to the bloodstream that elevated your risk of heart disease goes away. And there are genes that are protective, cancer suppressor genes, for example. And there are studies that show that lifestyle interventions turn those genes on. So this is why absolutely, DNA is not destiny, but dinner is. So on the one hand, tremendous opportunity for all of us to have more years in life, more life in years. But along with that power comes the responsibility to say, okay, so what I do really matters. I have to take it very seriously.