WEBVTT

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I would like to talk to you right now
about perhaps the most over-used

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and misunderstood word
in the English language: "freedom."

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Freedom has two parts: freedom from -
freedom from oppression,

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freedom from search and seizure;
and freedom to - freedom to choose.

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But freedom to choose has some
caveats, has some provisos.

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The one we ascribe
is called "personal responsibility",

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and that's an ideology.

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And there are some basic principles

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that we ascribe
to personal responsibility,

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that is, we have to have knowledge.

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The five-year old who accidentally
shoots his brother is not guilty,

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because he didn't have the knowledge.

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Access.

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We have 57,000 people being thrown off
voting rolls right now in America

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because of redistricting;
they don't have access.

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They can't have personal
responsibility to vote.

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And finally, affordability.

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You have to be able to afford your choice,

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and society has to be able
to afford your choice.

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An example: In California we've just
released 100,000 inmates

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who are drug addicts.

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We said, "Drug addicts
have to be locked up."

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You know what?

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We can't afford it.

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So, these are all caveats
to personal responsibility.

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And then the last one,
really important,

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is that your actions
can't hurt anyone else,

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because if they do,
then that's breaking the law.

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Well, the fact is,
we've got a healthcare crisis,

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and it's a big one.

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In fact, Medicare will be broke
by the year 2026.

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We do not have the money
to keep doing what we've been doing.

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And this healthcare crisis
is not due to physician reimbursements,

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it is not due to hospital charges,

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it is not due to infrastructure,
or administration.

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This healthcare crisis is due
to chronic metabolic disease.

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That's where the money's going.

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$245 billion dollars last year
in America for diabetes.

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$200 billion for dementia,
another chronic disease.

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And Obamacare promises us
that we're going to be able

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to put 32 million sick
people on the rolls,

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and we're going to to do it
by providing preventative services.

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Well, guess what?

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There are no preventative services
for these chronic metabolic diseases.

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They don't exist.

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The only thing that works is prevention,
and we don't have a prevention.

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So, what does this mean?

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This means that we're screwed.

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(Laughter)

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The fact is, that we cannot afford this.

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Where is this coming from?

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It's coming from this thing
called the obesity epidemic, right?

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Everyone says, "If only these people
could just eat less and exercise more,

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we would solve this problem;
it's their fault."

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That's where this comes from.

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You know, we have these things
called the seven deadly sins.

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We have absolved all five
of the other sins.

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We've absolved jealousy,
greed, wrath, pride, and lust.

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In fact, we have TV shows
that extort them.

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The only two that we have not
been able to get rid of,

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the only two that still stand
are gluttony and sloth.

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It's your fault.

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Well, you know what?

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I'm a pediatrician,
and I take care of kids.

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I have a hard time ascribing
personal responsibility to their obesity.

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In fact, we have an epidemic
of obese newborns.

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Obese newborns.

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Now, you want to assign them
personal responsibility?

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I take care of kids with brain tumors.

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You can see right here this arrow
pointing to a goombah

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sitting right in the middle
of this patient's energy balance pathway.

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A brain tumor that is causing
massive obesity.

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Let me tell you about
two of those patients.

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Here's a patient that I took care
of many years ago.

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She had a brain tumor,
and she gained 150 pounds.

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You can see her here
right now at 220 pounds.

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And we put here on an experimental
medication to lower her insulin level.

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Remember, insulin is the diabetes hormone,
it's also energy storage hormone.

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It's the hormone that tells your fat cells
to take up extra energy.

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There is no weight gain without insulin.

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And we knew that these patients
had very high insulin levels.

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So we gave her a drug to drop her insulin
in an experimental fashion.

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A week later, the mother called me up,
the kid hadn't lost any weight yet,

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and she says, "Doctor Lustig,
something's going on here."

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I go, "How do you mean?"

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"Well, we would go to Taco Bell,

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and she would eat five tacos
and an Enchirito,

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and she'd still be hungry.

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We just went to Taco Bell

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and she only ate two tacos,
and she was full.

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And she just vacuumed the house!"

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(Laughter)

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I go, "Really? Isn't that interesting."

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In fact, we did this many times,
and the exact same thing happened.

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And here she is, one year later
having lost 48 pounds,

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and feeling much better
about herself, as you can imagine.

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The next patient I'm going to show you
isn't even my patient.

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This is a beautiful 13 year old girl
who lives in Hawaii.

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Notice the lily in her hair.

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And one month after this picture
was taken, she was in a car accident,

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and she stroked her hypothalamus,

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that area of the brain where
that tumor was for the other patient.

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And this is her, one year later.

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Now, does anyone really want to tell me
that this is personal responsibility?

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That this was this young girl's fault?

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Well, I was giving grand rounds
at Kaiser, Honolulu,

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and they said maybe we should
put this girl on this same drug.

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And there I am with her.

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And her mother said,
"Yes, go ahead and try."

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And here she is one and a half years later
at her high school graduation.

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Now, does anybody really
want to make the argument

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that this is this kid's fault?

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I have a hard time with that.

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In fact, what we learned
from these experiments

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is that the behavior
is secondary to the biochemistry.

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When you fix the biochemistry,
the behavior improves,

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and we've seen it now in adults as well.

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So, everyone says
the behavior's the problem.

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No, it isn't.

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The biochemistry
underlying is the problem.

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Well, so now you say to me,

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"What about the rest of us?


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We don't have brain tumors."

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Well, in fact,
it's the exact same problem.

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Nothing's different.

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All of us now have insulin levels
three times higher than we used to.

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and the question, of course,
is where did that come from?

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Who in the audience has diabetes?

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Anybody?

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Must be a few of you, because 
diabetes is pretty big problem here.

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Here's the problem:
seven out of eight of you,

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seven out of eight people with diabetes

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don't even know they have it.

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You are blind to diabetes,
until you become blind from diabetes.

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So you don't even know
you have a problem yet.

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So here's the way to look at this.

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Here is the American population;
30% obese, 70% normal weight.

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The standard mantra is,

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"It's the obese people's fault because
80% of those obese people are sick."

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They have type 2 diabetes;
they have hyperlipidemia;

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they have cardiovascular disease;
they have hypertension;

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they have cancer; they have dementia;

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and they are breaking the bank.

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Those 80%, those 57 million people,

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if we could just get them to diet
and exercise, we could solve this problem.

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That's the standard mantra;

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this is incorrect.

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Because 20% of those obese people
are actually metabolically healthy.

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They will live a completely normal life,
die at completely normal age,

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not cost the tax payer a dime. 


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They're just that.

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Conversely, up to 40%
of the normal weight population

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have the exact same diseases.

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They get type 2 diabetes, hypertension,
dyslipidemia, cardiovascular disease.

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And you know what?

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They don't know they have a problem.

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When you add them up,
it's more than half the US population.

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In other words,
this is a public health crisis.

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Here is an example of how that works.

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Here are two people of equal weight;
one's healthy, one is sick.

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Want to take a guess
which one the sick one is?

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Can you tell?

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I can tell.

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The one in the bottom is sick; why?

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The guy on the top,
he's just got big love handles.

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The guy in the bottom has got fat
all around his organs,

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and that is what's making him sick.

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And this is called TOFI; T,O, F, I.


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Thin on the outside, fat on the inside.

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I venture to guess there's a few
TOFIs in the room right now,

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and you think you are just fine,
and you are not.

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So lets talk about the last public
health crisis that we experienced.

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HIV; remember HIV?


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1979; Patient Zero.

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1981; the term "AIDS" got coined.

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1986, Everett Koop said,
"You know, we've got a problem."

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When did HIV become
a public health crisis?

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1991.

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Why?

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Because Magic Johnson got HIV.

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And everybody said, "Holy ____,
this could happen to me."

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This really is something
where everyone is at risk.

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Because it's not a behavior,
it's an exposure.

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So the question is,
how do we resolve this?

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Well, here's the problem;
it's on this slide, right here.

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This is Coca Cola's "beating obesity"
campaign, "Coming Together."

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"Beating obesity will take
action by all of us,

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based on one simple common sense fact:

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All calories count, no matter
where they come from,

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including Coca-Cola,
and everything else with calories."

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A calorie is a calorie, and you can get
your calories from carrots,

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or you can get your calories
from cheesecake,

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or from Coca Cola,

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or anything else
with a "C" for that matter.

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It doesn't matter where
the calories come from,

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it's, "a calorie is a calorie",
that's what they say.

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Well, you know what?


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I don't believe in common sense.

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I believe in data.

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And the data say something else entirely.

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What the data say is some calories
cause disease more than others,

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because different calories
are metabolized differently,

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because a calorie is not a calorie.

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And when you believe that a calorie
is not a calorie, a whole world opens up,

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and actually, how to fix this problem
becomes very clear.

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This is because of our new diet.

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It is 40 years old now.
It is called "the Western diet",

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it is called "the industrial global diet",

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and it is basically
the processed food diet.

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And everyone of you
is eating it all the time,

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whether you like it or not.

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There are eight things wrong,


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not one, but eight things wrong
with processed food, and here they are.

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Three thing too little,
five things too much.

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Not enough fiber, not enough
omega-3 fatty acids,

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which you get from wild fish 
not farmed fish,

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not enough micro-nutrients,
all the vitamins and minerals.

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In addition, too much trans-fats,
but we know that they're coming down,

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branched-chain amino acids;

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they're amino acids you get
in corn-fed beef, chicken and fish,

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omega-6 fatty acids in seed oils,
alcohol, and finally, the big kahuna,

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the one that blows all the other
seven out of the water, sugar.

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Sugar, okay?

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We're going to talk about that
for the rest of the time.

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Does sugar cause diabetes?

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Everyone says, "Well, yeah,
but it's because of the calories."

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"Sugars are empty calories,"
that's the mantra.

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It is not; this is absolutely not true.

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Sugars are "toxic calories".

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In fact, studies from Europe show
that if you consume one soda per day,

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your risk for diabetes goes up 29%,
irrespective of the calories,

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irrespective of your weight,
irrespective of anything else you eat.

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We've shown that for every
150 calories the world consumes,

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diabetes prevalence goes up
a total of 0.1%, which is nothing.

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But if those 150 calories happen to be
a can of soda, diabetes goes up 11 fold.

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1.1%, and we're not consuming
one can of soda,

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we're consuming two and a half.

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So 29% of all the diabetes in the world


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is due to sugar, and sugar alone.

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This study actually satisfies
both the scientific and legal criteria

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for proximate cause.

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You have to be able to show
that something causes something else

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before you can do something about it.

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Well, we've proven it; we've shown it.

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It's shown here as well; same thing.

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Now, the question is,
why does this happen?

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Number one: sugar causes
liver fat accumulation.

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All that fat around the organs
that I just showed you?

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For sure, that's what that did.

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And that's not love-handle fat,
that's inside you.

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Number two: sugar's addictive.

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Weakly so, but it's everywhere,
it's like alcohol.

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And about 20% of people
are addicted to alcohol,

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probably about the same for sugar.

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So you can't stop.

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So this slide over here shows
the prevalence of diabetes

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worldwide as we speak right now.

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Who's worst?

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Saudi Arabia, Kuwait,
UAE, Qatar, and Malaysia.

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The worst.

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Why them?

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No alcohol.

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But they've got soft drinks
like they're going out of style.

00:14:23.362 --> 00:14:27.844
Because it's hot, and the water
supply's a question mark,

00:14:27.844 --> 00:14:30.667
and no alcohol.

00:14:30.667 --> 00:14:31.667
(Laughter)

00:14:31.667 --> 00:14:33.517
This is their reward.

00:14:34.487 --> 00:14:36.970
But you know what,
I'd rather have alcohol.

00:14:36.970 --> 00:14:40.866
Because you can only drink yourself
under the table once a day.

00:14:40.866 --> 00:14:43.976
(Laughter)

00:14:46.666 --> 00:14:51.028
But for soft drinks; all day, all night.

00:14:51.028 --> 00:14:54.278
Sugar in the morning, sugar
in the evening, sugar at supper time.

00:14:54.278 --> 00:14:55.941
That's what we're seeing.

00:14:55.941 --> 00:15:00.319
So, we've been overdosed.

00:15:00.319 --> 00:15:02.549
The American Heart Association says

00:15:02.549 --> 00:15:06.663
we should be consuming
six to nine teaspoons of sugar per day;

00:15:06.663 --> 00:15:08.793
we are up to 22.

00:15:08.793 --> 00:15:15.402
And 80% of foods that are available
in the American grocery store today

00:15:15.402 --> 00:15:16.952
are spiked with added sugar.

00:15:16.952 --> 00:15:20.950
And that's for the food industry's
purposes, not for yours.

00:15:20.950 --> 00:15:23.624
So, no access.

00:15:23.624 --> 00:15:26.834
You don't have access
because it doesn't exist.

00:15:26.834 --> 00:15:29.166
Real food is hard to find.

00:15:29.166 --> 00:15:30.736
Number two:

00:15:30.736 --> 00:15:33.776
How about that there are 56
names for sugar,

00:15:33.776 --> 00:15:35.876
so you don't even know
what you're consuming.

00:15:35.876 --> 00:15:37.858
And here there are.

00:15:37.858 --> 00:15:39.601
No knowledge.

00:15:39.601 --> 00:15:40.711
And how about this?

00:15:40.711 --> 00:15:43.041
Everybody knows what
a "Nutrition Facts" label is.

00:15:43.041 --> 00:15:45.609
There's a number
over there in the purple.

00:15:45.609 --> 00:15:48.659
It's called the "Dietary Value".

00:15:48.659 --> 00:15:51.141
Notice, there's none for sugar,
and that's on purpose

00:15:51.141 --> 00:15:53.947
because they don't want you to know
how much is too much.

00:15:54.687 --> 00:15:56.737
So, no knowledge.

00:15:56.737 --> 00:15:59.791
How about the National
School Lunch Program?

00:16:00.761 --> 00:16:02.761
Six cents extra.

00:16:03.581 --> 00:16:06.397
Six cents, Michelle Obama
got out of Congress.

00:16:06.397 --> 00:16:08.577
That's not even enough for two grapes.

00:16:08.577 --> 00:16:12.496
And, if you are eating school breakfast,

00:16:12.496 --> 00:16:15.246
you're getting Fruit Loops
and a glass of orange juice.

00:16:15.246 --> 00:16:20.105
That's 11 teaspoons of sugar;
you're already over your limit.

00:16:20.105 --> 00:16:22.366
You want to know why we have a problem?

00:16:22.366 --> 00:16:24.456
This is why we have a problem.

00:16:24.966 --> 00:16:27.012
So everyone says, "Education!"

00:16:27.012 --> 00:16:31.002
"Educate the public, educate
the populace, tell them what's going on!"

00:16:31.022 --> 00:16:34.779
Except for one thing: education hasn't
worked for any other substance of abuse.

00:16:35.509 --> 00:16:39.147
Did Nancy Reagan's "Just Say No" work?

00:16:39.147 --> 00:16:40.797
(Laughter)

00:16:40.797 --> 00:16:42.406
Really?

00:16:42.406 --> 00:16:43.606
(Laughter)

00:16:43.606 --> 00:16:45.712
And you know what?

00:16:45.712 --> 00:16:50.448
I can prove that it doesn't work
because here is the stock prices

00:16:50.448 --> 00:16:54.234
against the S&P 500
for McDonald's, Coke, and Pepsi,

00:16:54.234 --> 00:16:57.559
and look at what happened
at the economic downturn in 2008.

00:16:57.559 --> 00:16:59.751
They did very well, thank you.

00:16:59.751 --> 00:17:03.271
In fact, if you want make money,
invest in a food company.

00:17:03.841 --> 00:17:06.546
So, where does that leave us?

00:17:06.546 --> 00:17:10.796
It leaves us with this question
of freedom and personal responsibility.

00:17:10.796 --> 00:17:13.694
What does personal
responsibility really mean?

00:17:13.694 --> 00:17:19.274
Well, if the information is kept secret
and you don't have knowledge,

00:17:19.274 --> 00:17:23.285
if your access is limited
because you can't even find it,

00:17:23.285 --> 00:17:25.805
and if society can't afford it,

00:17:25.805 --> 00:17:30.790
and we can't even give our kids
something healthy to eat,

00:17:30.790 --> 00:17:33.153
is it really personal responsibility?

00:17:33.153 --> 00:17:38.633
And lastly, if your decision
to drink a soda

00:17:38.633 --> 00:17:42.424
lands you in the emergency room,
and costs me dollars,

00:17:42.424 --> 00:17:46.021
and if your decision to be fat and sick

00:17:46.021 --> 00:17:50.351
costs your employer $2750

00:17:50.351 --> 00:17:54.366
per employee, whether you're obese or not,
you know what that is?

00:17:54.366 --> 00:17:57.216
That's not called freedom,
that's called anarchy.

00:17:57.226 --> 00:17:58.672
That's what we've got.

00:17:58.672 --> 00:18:03.895
So the libertarians say, "Wait a second;
don't tell me what to eat!"

00:18:03.895 --> 00:18:06.898
Well, you know what?
You've already been told what to eat.

00:18:06.898 --> 00:18:09.128
Where were you for the last 40 years

00:18:09.128 --> 00:18:12.709
as your food supply was being
changed under your nose.

00:18:12.709 --> 00:18:14.849
Were you protesting then?

00:18:14.849 --> 00:18:17.971
The libertarians say,
"Get government out of my kitchen!"

00:18:17.971 --> 00:18:20.931
You know, I don't want
government in my kitchen either,

00:18:20.931 --> 00:18:25.349
unless there's somebody
more dangerous already there.

00:18:27.789 --> 00:18:32.735
So the real question is, who the hell
do you want in your kitchen?

00:18:32.735 --> 00:18:37.342
The government, who will take
your freedom and your wallet?

00:18:37.342 --> 00:18:38.847
Or the food industry,

00:18:38.847 --> 00:18:43.407
whose already taken your freedom,
your wallet, and your health?

00:18:43.407 --> 00:18:45.069
That's your only choice.

00:18:45.499 --> 00:18:48.079
Now, having said all this,

00:18:49.249 --> 00:18:52.979
the food industry
is composed of a lot of people,

00:18:52.979 --> 00:18:54.027
and you know what?

00:18:54.027 --> 00:18:56.306
They really want
to do the right thing, they do.

00:18:56.306 --> 00:18:59.425
Individually, they would actually
like to do the right thing.

00:18:59.425 --> 00:19:03.363
And I have met with these people,
and they are actually very nice people,

00:19:03.363 --> 00:19:06.674
but, they work for a food company.

00:19:07.834 --> 00:19:11.474
and contrary to what
the Supreme Court says,

00:19:11.474 --> 00:19:13.841
corporations are not people.

00:19:14.481 --> 00:19:18.721
Because corporations have a fiduciary
responsibility to their stockholders,

00:19:18.721 --> 00:19:20.259
and people don't.

00:19:20.869 --> 00:19:26.904
Corporations get three month profit
cycles, and Wall Street earning reports.

00:19:26.904 --> 00:19:29.194
And they have to make those reports.

00:19:29.194 --> 00:19:32.744
So I've met with the food industry,
and I will tell you about one story,

00:19:32.744 --> 00:19:36.113
which will remain nameless,

00:19:36.113 --> 00:19:40.468
They told me very straight out,
ten scientists, ten corporate executives,

00:19:40.468 --> 00:19:42.558
they said, "You know, we can change.

00:19:42.558 --> 00:19:43.588
We've changed before.

00:19:43.588 --> 00:19:46.440
we had to change back in the 80s
when we went low fat,

00:19:47.350 --> 00:19:50.330
with two provisos;

00:19:50.350 --> 00:19:54.320
we wont go it alone,
and we can't lose money."

00:19:55.530 --> 00:19:57.748
Those are two non-starters today.

00:19:57.748 --> 00:19:59.288
So what does that mean?

00:19:59.288 --> 00:20:01.678
That means that they
have to be told what to do,

00:20:01.678 --> 00:20:03.688
and they have to do it
all at the same time

00:20:03.688 --> 00:20:05.898
so that there's no
competitive disadvantage.

00:20:05.898 --> 00:20:07.548
What does that mean?

00:20:07.548 --> 00:20:09.714
That means government.

00:20:10.254 --> 00:20:13.162
But governments are complicit
and complacent.

00:20:13.162 --> 00:20:14.921
They're getting paid off.

00:20:14.921 --> 00:20:17.891
Over half of Congress takes money
from the food industry.

00:20:17.891 --> 00:20:20.945
And 6% of our exports are food.

00:20:20.945 --> 00:20:24.085
What do you think what happen
if all of a sudden we told the world,

00:20:24.085 --> 00:20:25.995
"You know, all that shit we put in food?

00:20:25.995 --> 00:20:28.088
It really isn't so good for you."

00:20:29.064 --> 00:20:32.631
What happened when that one downer cow
went from Canada to Washington state?

00:20:32.631 --> 00:20:36.630
That was at the end of meat sales
to Britain and South Korea for two years.

00:20:36.870 --> 00:20:39.870
So, they're on the other side.

00:20:40.950 --> 00:20:45.974
But we've got a crisis,
because we will not have healthcare.

00:20:47.734 --> 00:20:51.284
Here is a report that just came out
from an investment bank,

00:20:51.284 --> 00:20:53.546
an international investment
bank, Credit Suisse,

00:20:53.546 --> 00:20:59.862
called Sugar Consumption at a Crossroads,
and this is a direct quote from this tome:

00:20:59.862 --> 00:21:05.439
"We believe higher taxation on sugary food
and drinks would be the best option

00:21:05.439 --> 00:21:07.599
to reduce intake and fund
the healthcare costs

00:21:07.599 --> 00:21:09.517
associated with diabetes and obesity."

00:21:09.517 --> 00:21:13.562
An investment bank
is calling for taxation.

00:21:13.562 --> 00:21:17.802
That's how big and bad
this problem has gotten.

00:21:20.982 --> 00:21:26.603
I believe food should
confer wellness, not illness,

00:21:26.603 --> 00:21:27.823
and it used to.

00:21:27.823 --> 00:21:28.823
But you know what?


00:21:28.823 --> 00:21:30.907
This is a public health crisis,

00:21:30.907 --> 00:21:35.607
and you cannot solve public health
crisis one person at a time.

00:21:35.607 --> 00:21:41.494
Here is a list of diseases that were all
personal responsibility issues,

00:21:41.494 --> 00:21:45.168
except for the sheer gravity
of each of them,

00:21:45.168 --> 00:21:47.898
became a public health crisis.

00:21:47.898 --> 00:21:51.976
Why don't we add sugar to the list?

00:21:53.586 --> 00:21:56.891
Personal responsibility isn't ideology.

00:21:56.891 --> 00:22:00.845
It's the elephant in the kitchen,
and we can't afford it.

00:22:01.405 --> 00:22:05.342
What we need is a policy
based in biology.

00:22:05.342 --> 00:22:06.892
And it's got a name.

00:22:06.892 --> 00:22:08.843
It's called real food.

00:22:09.573 --> 00:22:11.633
And the only way we can solve this

00:22:11.633 --> 00:22:14.583
is by kicking that elephant
out of the kitchen.

00:22:14.583 --> 00:22:15.841
Thank you.

00:22:15.841 --> 00:22:17.551
(Applause)